Geospatial analysis of fatal road traffic accidents following ambulance responses in Cape Town

Abstract

Road traffic accidents (RTAs) are a leading global health concern and are projected to rank as the seventh leading cause of death by 2030, with low- and middle-income countries, particularly in Africa, facing the greatest burden. In Cape Town, South Africa, pedestrians are disproportionately vulnerable to RTA fatalities. This study aimed to examine demographic, temporal and geographic patterns of fatal RTAs to guide safety and emergency response interventions. Using data from the Western Cape Government Health and Wellness Emergency Medical Services (WCGHW EMS) from January 2021 to May 2024, descriptive statistics and geospatial analyses were conducted on 784 RTA cases, including 167 fatalities. Males accounted for 70.7% of deaths, and pedestrian accidents represented 65.3% of fatalities, with nighttime RTAs posing nearly twice the mortality risk of daytime incidents. Fatalities clustered in poorly lit eastern suburbs, including Gugulethu, Nyanga, Mitchells Plain and Khayelitsha, which had a two-fold higher mortality risk compared to other areas. These findings highlight the critical need for improved infrastructure, including better lighting and pedestrian facilities, alongside enhanced emergency response systems. Targeted interventions addressing these vulnerabilities are essential to reducing RTA fatalities in Cape Town and similar settings.