Development and Implementation of Integrated Road Traffic Injuries Surveillance – India (IRIS-India): A Protocol

  • Bontha V Babu ORCID Mail Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India
  • Kamalabai R John ORCID Apollo Institute of Medical Science & Research, Chittoor, Andhra Pradesh, India
  • Ponnaiah Manickam ORCID ICMR - National Institute of Epidemiology, Chennai, India
  • Jugal Kishore ORCID Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
  • Rajesh Singh ORCID Garhwal Community Development and Welfare Society, Tehri-Garhwal, India
  • Daya K Mangal ORCID Indian Institute of Health Management Research, Jaipur, India
  • Ashish Joshi ORCID Foundation for Health Technologies Society, New Delhi, India
  • Mohan Bairwa ORCID Indian Institute of Health Management Research, Jaipur, India
  • Yogita Sharma ORCID Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India
Accidents, Traffic, India, Surveillance, Trauma


Road traffic accidents stand as one of the leading causes of mortality and morbidity across the globe. The reasons for the high burden of road traffic injuries (RTIs) in developing countries are increasing in the number of motor vehicles, poor enforcement of traffic safety regulations, inadequacy of health infrastructure and poor transport facility. However, the systematic collection of road traffic data is not well developed in many developing countries including India and under-reporting of RTIs and deaths are common. Hence, surveillance of RTIs is recommended to assess the burden, to identify high-risk groups, to establish an association with probable risk factors and to plan interventions to control the RTIs. The broad objective of this study is to establish an electronic-based comprehensive and integrated RTI surveillance system, to assess the burden of RTIs, its risk factors and outcomes across rural and urban settings in India. This study with the support of the Indian Council of Medical Research (ICMR) is progressing in three cities (Chennai, Delhi and Jaipur) and two rural areas (Chittoor and Tehri-Garhwal). At each centre, major sources of data can be categorized under two categories including health facilities and community. In urban areas, one trauma centre, one private hospital and a community of 10000-population are included in the study. In rural areas, a district hospital, a private nursing home and two sub-centres areas of different primary health centres at each site are included for the surveillance. Passive surveillance is done at the trauma centres/district hospitals, while active surveillance is done in private hospitals/nursing homes, sub-centres and communities. Before establishing the surveillance system, situational analysis has been undertaken. Surveillance-related software was developed during the preparatory stage. This electronic surveillance platform allowed to gather data electronically across multiple sites. This internet-enabled surveillance platform has several modules to capture and analyse the data. The present study provides a model of surveillance including both passive and active surveillance to cover maximum number of RTIs. This study further provides the first comprehensive epidemiology of RTIs. The results of these studies will contribute to the setting of research and investment priorities to tackle the burden of RTIs.


Download data is not yet available.


1. Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. Global, regional, and national life expectancy, all-cause and cause-specific mortality for 249 causes of death, 1980±2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459-544.
2. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11): e442.
3. Kassebaum NJ, Arora M, Barber RM, Bhutta ZA, Brown J, Carter A, et al. Global, regional, and national disability-adjusted life years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2015: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 Study. Lancet. 2016;388(10053):1603-58.
4. Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, et al. editors. World report on road traffic injury prevention: summary. Geneva: World Health Organization; 2004.
5. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095-128.
6. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197-223.
7. World Health Organization. Global status report on road safety 2015. Geneva: World Health Organization, 2015.
8. Babu BV, Sharma Y. Health systems research initiative to tackle growing road traffic injuries in India. J Emerg Pract Trauma 2019;5(1):2-7.
9. Grossman DC, Kim A, Macdonald SC, Klein P, Copass MK, Maier RV. Urban-rural differences in prehospital care of major trauma. J Trauma. 1997;42(4):723-9.
10. Gururaj G. Road traffic deaths, injuries and disabilities in India: Current scenario. Natl Med J India; 2008;21(1):14-20.
11. Benegal V. India: alcohol and public health. Addiction. 2005;100(8):1051–6.
12. World Health Organization (WHO). Global status report on alcohol and health, Geneva; 2014. [Accessed on 12 February 2019].
13. World Health Organization [Internet]. Global status report on road safety 2013: supporting a decade of action. road_safety_status/2013/en/ [Accessed on 19 June 2018].
14. Wesson HK, Boikhutso N, Bachani AM, Hofman KJ, Hyder AA. The cost of injury and trauma care in low-and middle-income countries: a review of economic evidence. Health Policy Plan. 2014;29(6):795-808.
15. Mashreky S, Rahman A, Khan T, Faruque M, Svanström L, Rahman F. Hospital burden of road traffic injury: major concern in primary and secondary level hospitals in Bangladesh. Public Health. 2010;124(4):185-9.
16. Reddy G, Negandhi H, Singh D, Singh AJ. Extent and determinants of cost of road traffic injuries in an Indian city. Indian J Med Sci. 2009;63(12):549-56.
17. Silcok BR. Guidelines for estimating the costs of road crashes in developing countries. London: Department for International Development, 2003.
18. Razzak JA, Bhatti JA, Ali M, Khan UR, Jooma R. Average out-of-pocket healthcare and work-loss costs of traffic injuries in Karachi, Pakistan. Int J Inj Contr Saf Promot. 2011;18(3):199-204.
19. Mohan D. The road ahead: traffic injuries and fatalities in India. Delhi: Indian Institute of Technology, Transportation Research and Injury Prevention Program, 2004.
20. Haddon Jr W. Advances in the epidemiology of injuries as a basis for public policy. Public Health Rep. 1980;95(5):411-21.
21. National Crime Records Bureau. Accidental Deaths & Suicides in India – 2015. New Delhi: National Crime Records Bureau, Ministry of Home Affairs, Government of India; 2017 [Accessed at:].
22. World Health Organization. Data Systems – A Road Safety Manual for Decision-Makers and Practitioners. Geneva: World Health Organization, 2010.
23. Khorshidi A, Ainy E, Soori H, Sabbagh MM. Iranian road traffic injury project: assessment of road traffic injuries in Iran in 2012. J Pak Med Assoc. 2016;66(5):517–20.
24. Shahbazi F, Hashemi Nazari SS, Soori H, Khodakarim S. Socioeconomic Inequality in Mortality from Road Traffic Accident in Iran. J Res Health Sci. 2019;19(1):e00437.
25. Azami-Aghdash S, Sadeghi-Bazargani H, Shabaninejad H, Abolghasem Gorji H. Injury epidemiology in Iran: a systematic review. J Inj Violence Res. 2017;9(1):27-40.
26. Razzak JA, Shamim MS, Mehmood A, Hussain SA, Ali MS, Jooma R. A successful model of road traffic injury surveillance in a developing country: process and lessons learnt. BMC Public Health; 2012;12:357.
27. Holder Y, Peden M, Krug EG, Lund J, Gururaj G, Kobusingye O. Injury Surveillance Guidelines. Geneva: WHO; 2001.
28. World Health Organization. World report on Road Traffic Injury Prevention. Geneva: World Health Organization; 2004.
29. Khorasani-Zavareh D, Sharifian S. Challenges of Establishing a Traffic Surveillance System in Iran: The Requirement of Providing a Unified Definition for "Traffic Surveillance System". Safety Promot Inj Prev. 2017;5(2):59-60.
30. Singh D, Singh SP, Kumaran M, Goel S. Epidemiology of road traffic accident deaths in children in Chandigarh zone of North West India. Egypt J Forensic Sci 2016;6(3):255-60.
How to Cite
Babu B, John K, Manickam P, Kishore J, Singh R, Mangal D, Joshi A, Bairwa M, Sharma Y. Development and Implementation of Integrated Road Traffic Injuries Surveillance – India (IRIS-India): A Protocol. Adv J Emerg Med. 4(2):e35.
Ongoing research (selected proposal)

Most read articles by the same author(s)