We identified risk factors for road traffic injuries among road users who received treatment at two major trauma hospitals in
urban Gambia. The study includes pedestrians, bicyclists, motorcyclists, and drivers/passengers of cars and trucks. We examined
distributions of injury by age, gender, collision vehicle types and vehicle category, and driver and environment factors. Two hundred
and fifty-four patients were included in the study. Two-thirds were male and one-third female. Two-thirds (67%) of road traffic
injuries involved pedestrians, bicyclists, and motorcyclists; and these were more common during weekdays (74%) than weekends.
Nearly half (47%) of road traffic injuries involved pedestrians. One-third (34%) of injured patients were students (mean age of
students was less than 14 years), more than half (51%) of whom were injured on the roadway as pedestrians. Head/skull injuries were
common. Concussion/brain injuries were 3.5 times higher among pedestrians, bicyclists, and motorcyclists than vehicle occupants.
Crashes involving pedestrians were more likely to involve young people (<25 years; aOR 6.36, 95% CI: 3.32–12.17) and involve
being struck by a motor car (aOR 3.95, 95% CI: 2.09–7.47). Pedestrians contribute the largest proportion of hospitalizations in the
Gambia. Young pedestrians are at particularly high risk. Prevention efforts should focus on not only vehicle and driver factors, but
also protecting pedestrians, bicyclists, and motorcyclists.