# Community-Based Household Survey Among Children Aged 5-18 to Identify Disability Burden and Health-Related Quality of Life Following Road Traffic Accidents in Ujjain, India

## TL;DR

This study surveyed children in India to assess their quality of life after road accidents, finding significant pain and injury burdens linked to poor safety practices.

## Contribution

The study demonstrates the feasibility of using EQ-5D-5L to assess HRQoL in children post-RTA in low-resource settings.

## Key findings

- Pain and discomfort were the most severe issues reported by children after road traffic accidents.
- Lower extremity injuries had the highest severity index according to the EQ-5D-5L.
- Two-wheeler-related accidents and low helmet use were major contributors to injury burden.

## Abstract

Introduction: The objective of the study was to report the health-related quality of life (HRQoL) following road traffic accidents (RTAs) among children.

Methods: A community-based survey using the Hindi version of the European Quality-of-Life five-dimension questionnaire (EQ-5D-5L) was conducted to collect data from the community. The survey included 2,620 households from urban and rural areas of Ujjain, India.

Results: From these households, 229 children aged 5-18 years with a history of RTA in the past one year were identified, with 27%, 63%, and 10% reporting mild, moderate, and severe injuries, respectively, based on the length of hospitalization. Motorcycles, bicycles, and pedestrians constituted most RTAs. Helmet use was low (12%). EQ-5D-5L revealed that the most severe and extreme problem was pain and discomfort, whereas the least severe problem was usual activity and self-care. The most common (65%) injuries were either abrasion or fracture and dislocation. EQ-5D-5L severity index was maximum (mean 72) for lower extremity injuries.

Conclusions: The results highlight the feasibility and importance of using EQ-5D-5L to measure HRQoL in children following RTAs in low-resource settings. Pain/discomfort and lower extremity injuries significantly impair the quality of life, even one year after injury. The high burden from two-wheeler-related injuries and extremely low helmet use underscore the urgent need for creating awareness of road safety interventions, stricter enforcement of helmet laws, and child-focused rehabilitation programs in India.