Relationship between mechanisms and activities at the time of pedestrian injury and activity limitation among school adolescents in Kathmandu, Nepal.

This study assessed the relationship between pedestrian activity at the time of injury, the type of vehicle involved and resulting activity limitation among school adolescents in the Kathmandu and Lalitpur districts of Nepal. A cross-sectional study of 1557 students in grades 6-8 across 14 schools was conducted using a self-administered questionnaire from August to September 2003. Twenty-three percent of adolescents reported pedestrian injuries, 38% were from urban and 21% from semi-urban areas. Adolescents were commonly injured by motorcycles and motor vehicles while crossing the road; however, while walking and playing, they were commonly injured by bicycles and motorcycles. Bicycles and motor vehicles were less likely to be involved in injury while crossing the roads and playing, respectively (p < 0.001). Activity was more likely to be limited for a longer period of time (> 7 days) with injuries endured while crossing the road (p < 0.001). In urban areas, boys and girls were more likely to be injured while crossing the road and walking, respectively (p < 0.05), and both were commonly injured by motorcycles. In semi-urban areas, boys and girls were commonly injured while walking and were more likely to be injured by motorcycles and bicycles, respectively (p < 0.05). In both areas, more boys than girls were injured while playing. These findings have important implications for pedestrian safety interventions in poor countries.