Burden and Risk Factors for Unintentional Injuries in Tanzania: Findings from a Nationwide Population-based Survey

Background Unintentional injuries (UIs), including road traffic crashes (RTCs), falls, drowning and burns, cause over 70% of 4.4 million injury-related deaths annually, with 90% occurring in Low- and Middle-Income Countries. Lack of population-based data limits development of effective preventive strategies. We aimed to determine prevalence and associated factors of UIs among adults in Tanzania. Methods The study was part of the Tanzania STEPS Survey 2023 conducted across all regions in Tanzania Mainland and Zanzibar. Adults aged 18–69 years were selected using a three-stage stratified cluster sampling technique. A sample of 4,320 individuals (one per household) was targeted for selection from 288 Enumeration Areas, with 15 households randomly selected per area. The World Health Organization’s STEPS questionnaire assessed UIs prevalence and associated factors. Data was collected via the eSTEPS platform. The primary outcome was prevalence of UIs, secondary outcomes were risk factors for UIs and risky behaviors. Results The STEPS Survey response rate was 82.6% (3,565/4,320). Of these 17.5% of respondents reported UIs in the past 12 months, with 9.2% involved in RTC. Among RTC victims, 65.5% sustained injuries requiring medical attention. Male gender [AOR = 2.1, 95% CI 1.5–2.9], current alcohol use [AOR = 1.5, 95% CI 1.04–2.1], and recent depressive episode [AOR = 1.7, 95% CI 1.2–2.5] were significantly associated with RTC involvement. 10% of respondents reported non-RTC injuries requiring medical attention. Falls (57.4%) and cuts (29%) caused most non-RTC injuries. Male gender [AOR = 1.7, 95% CI 1.3–2.2] and depression [AOR = 2.5, 95% CI 1.9–3.3] were also significantly associated with non-RTC injuries. Nearly half (46.9%) of either drivers or passengers reported not wearing seat belts, with less occurrence in females than males (56.0% vs. 41.2%, p < 0.001). Similarly, 62.3% of motorcyclists did not always use helmets, with females more likely to not wear helmets compared to males (75.9% vs. 49.8%, p < 0.001). Conclusions This nationwide survey highlights a substantial burden of UIs in Tanzania. RTCs coupled with low adherence to road safety precautions remain a major concern. Non-RTC-related injuries impact a similar proportion of the population as RTC and thus supports the need for comprehensive injury prevention strategies.