Epidemiological patterns of motorcycle-related injuries in Cameroon: A comparative analysis of motorcycle users and pedestrians.

Motorcycles are a common mode of transport in major Cameroonian cities, contributing to a rising burden of injuries among both users and pedestrians. These groups differ in exposure, mechanisms, and vulnerability, yet both bear a disproportionately high injury burden. However, comparative data on their epidemiological patterns and outcomes remain scarce. To support targeted prevention policies, we analysed trauma registry data to describe demographic, crash, injury, clinical, and outcome characteristics across both populations. This was a retrospective analysis of the Cameroon Trauma Registry (CTR), which collects information on injured patients presenting to 10 hospitals across seven of the 10 regions of Cameroon. Patients presenting with motorcycle-related injuries between June 1st 2022 and May 31st 2023 were assessed for demographic, crash, injury, clinical patterns of care and outcomes variables and compared using χ² or Fisher's exact tests for categorical data. The analysis was done using R version 4.2.1. A total of 2,757 motorcycle-related injury patients were included from the CTR database, including 2,339 (84.8%) motorcycle users and 418 (15.2%) pedestrians. Motorcycle users were mostly aged 15-34 years (59.1%) and males (83.0%), while pedestrians were frequently aged ≥60 years (23.4%) and females (37.8%). Helmet use among motorcycle users was low (3.0%). Alcohol involvement was more frequent among users (14.2%) than pedestrians (7.4%, p = 0.001). Most injuries occurred during work for users (33.1%) and during leisure for pedestrians (77.5%, p < 0.001). Severe multi-region injuries (abbreviated injury severity ≥3) were more common in users (21.9%) than pedestrians (16.1%, p = 0.014). Hospital admissions were high in both motorcycle users (60.2%) and pedestrians (58.4%); 6.2% required intensive care, and 2.2% underwent immediate surgery. Functional outcomes were similar: 44.8% had minor and 19.9% had major disability at discharge; 3.6% died during hospitalization. Motorcycle-related injuries in Cameroon disproportionately affect young male motorcycle users, with low helmet use, higher rates of alcohol use and severe trauma, together with older female pedestrians. Despite differing profiles, both motorcycle users and pedestrians face high disability and hospitalization rates. Targeted safety strategies are urgently needed to address these overlapping and distinct risks.