Burden and Determinants of Road Traffic Injuries in Low- and Middle-Income Countries: A Systematic Review

Road traffic injuries (RTIs) are a leading cause of preventable death and disability globally, with 1.35 million deathsand 20–50 million non-fatal injuries reported annually. The burden disproportionately affects low- and middle-incomecountries (LMICs), including Bangladesh, where rapid motorization, inadequate infrastructure, weak enforcement, andlimited trauma care exacerbate risks. Vulnerable road users such as pedestrians, cyclists, and motorcyclists account forthe majority of fatalities, while young adults and males are particularly affected. The economic impact is substantial,with losses estimated at 2–3% of GDP in Bangladesh. This systematic review synthesizes evidence from PubMed,WHO, World Bank, and national sources on the epidemiology, risk factors, economic burden, interventions, andpolicy frameworks for RTIs. Key contributing factors include speeding, driver fatigue, traffic rule violations, poor roadconditions, and low use of helmets and seatbelts. Despite national strategies and global frameworks like the UN Decadeof Action for Road Safety (2021–2030), implementation gaps persist, with less than 1% of transport budgets allocatedto safety initiatives. Effective reduction of fatalities requires systemic approaches integrating engineering, enforcement,education, and emergency care, alongside strengthened data systems and sustained investment. Prioritizing RTIs inhealth and transport policy is essential to reduce mortality, economic losses, and achieve meaningful improvements inroad safety in Bangladesh and other LMICs.