Helmet Use among Motorcycle Riders in Lomé: Knowledge, Attitudes, Practices, and Implications for Preventing Head Injuries

Abstract

Background: Traumatic brain injury (TBI) is a significant public health issue in Togo, where motorcycles are the primary cause of road traffic accidents. Helmet use is an effective preventive measure; however, compliance remains low, necessitating urgent action. Methods: We conducted a cross-sectional study from February to May 2024 in Lomé (Golfe 1 commune). Using convenience sampling, 404 motorcycle riders were recruited at service stations and parking areas, based on a minimum sample size calculated with Cochran’s formula. Data were collected through direct observations and structured interviews. Logistic regression was used to identify factors associated with helmet use. Results: The average age of riders was 32.8 years, and 82.7% were male. Overall, helmet use was observed in 83.1% of riders, but only 41.3% consistently wore a properly fastened helmet. Reported barriers included heat (41.7%), forgetfulness (27.8%), cost (17.2%), and short trips (13.3%). While 82% had good knowledge and 72.5% had favorable attitudes, gaps in practice remained. Predictors of consistent helmet use included being aged 28 - 37 years, having a higher education, working as a motorcycle taxi driver, and possessing good knowledge. Notably, no participant held a valid driver’s license, underscoring significant policy gaps in road safety enforcement. Addressing heat as a barrier may involve promoting or subsidizing helmets with improved ventilation, which could encourage consistent use in hot climates. Conclusion: Although awareness is high, consistent helmet use remains inadequate in Lomé. This study highlights the need for improved enforcement, affordable safety measures, and enhanced road safety education to reduce the TBI burden in Togo.