Motorcyclist visibility materials uptake and associated factors toward injury prevention in Cameroon

Abstract Background Commercial motorcycle riders in Cameroon are highly vulnerable road users, often exposed to traffic injuries and fatalities. Low visibility, especially in poor lighting, is a key contributor to crashes. Although visibility materials such as reflective jackets, stickers, and lights help prevent injuries, awareness and consistent use remain limited in many low- and middle-income settings. Understanding awareness and uptake of visibility materials among riders is essential for designing targeted safety interventions in high-risk districts like Limbe and Tiko. Methods A community-based cross-sectional study was conducted among 499 commercial motorcycle riders aged ≥18 years in Limbe and Tiko Health Districts, Cameroon. Severely ill persons were excluded. Participants were recruited consecutively at motorcycle pick-up points. Trained assistants used structured questionnaires to collect data on socio-demographics, riding habits, knowledge, attitudes, and use of visibility materials. Descriptive statistics and logistic regression were used for analysis. Ethical clearance was obtained from the University of Buea (2024/2490-03/UB/SG/IRB/FHS). Results Of the 499 riders, 254 (50.9%) wore reflective vests/jackets, and 99 (17.8%) motorcycles had reflective strips. Functional headlamps were present in 428 (85.8%), rear lights in 286 (57.3%), brake lights in 286 (57.3%), and all four trafficator lights in 219 (43.9%). Overall, 15.0% had high knowledge, 20.2% had positive attitudes, and 7.6% had good practices toward visibility and road safety. Factors significantly associated with visibility material use included past road traffic injury (aOR=1.87; 95%CI: 1.12-3.12), obeying traffic regulations (aOR=3.59; 95%CI: 2.31-5.57), willingness to spend money on materials (aOR=2.99; 95%CI: 1.84-4.88), and license ownership (aOR=1.71; 95%CI: 1.08-2.72). Key messages • Only 7.6% of commercial motorcyclists showed good practices toward visibility; low uptake highlights urgent need for targeted road safety interventions. • Use of visibility materials was significantly linked to prior road injury, traffic law obedience, and license ownership.