INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
Fatal Accidents in Nairobi: A Statistical Analysis of Road Traffic,  
Burn, Drowning, and Occupational Injuries  
Wangai Kiama, M Med (Path), Frcpath (ECSA)  
Department of Pathology, Egerton University, P.O BOX 536-20115, Egerton-Njoro, Kenya  
DOI: https://dx.doi.org/10.51244/IJRSI.2025.12110022  
Received: 18 November 2025; Accepted: 27 November 2025; Published: 03 December 2025  
ABSTRACT  
Background: Accidental deaths are a significant public health concern in Nairobi, Kenya, with road traffic  
accidents (RTAs), burns, and drowning being the leading causes.  
Objectives: The study aimed to evaluate the prevalence and distribution of accidental deaths in Nairobi, focusing  
on RTAs, burns, and drowning, identify vulnerable groups.  
Methods: A descriptive prospective study was conducted at the City Mortuary in Nairobi between June 1, 2009,  
and May 31, 2010. A total of 2,566 autopsies were performed during the study period, with 2,278 (88.8%)  
attributed to violent causes. The study focused on accidental fatalities, particularly RTAs, burns, drowning, and  
other causes.  
Results: RTAs were the primary cause of accidental deaths, accounting for 87.3% of all fatalities (929 cases).  
Among RTA victims, pedestrians (46.9%) and cyclists (25.2%) were the most affected. Chi-square analysis  
revealed a significant relationship between road user category and accident type (Chi-square = 984.1, p < 0.001).  
Other causes included burns (4.5%), drowning (4.0%), and falls (2.2%). ANOVA results showed significant  
differences in fatality rates among road user groups (F(3, 925) = 37.82, p < 0.001).  
Conclusion: RTAs, particularly those involving pedestrians and cyclists, are the leading cause of accidental  
deaths in Nairobi. Burns and drowning also remain significant public health concerns.  
Recommendations: To improve safety across various sectors, collaboration between government agencies,  
community organizations, and public health authorities is essential, including developing dedicated pedestrian  
and cyclist lanes, enhancing fire safety , promoting water safety ,upgrading emergency services and trauma care  
facilities.  
Keywords: Accidental deaths, RTA, Autopsy, Nairobi,  
INTRODUCTION AND LITERATURE REVIEW  
Accidental deaths, particularly road traffic accidents (RTAs), present a significant public health challenge in  
Nairobi, reflecting trends seen across many low- and middle-income countries (LMICs). With a population of  
over 4.5 million people, the city's rapid urbanization, increasing vehicular traffic, and limited infrastructure  
exacerbate the issue. RTAs are the leading cause of accidental fatalities, with pedestrians being the most  
vulnerable road users. Poor pedestrian infrastructure, such as the lack of sidewalks, crossings, and signage,  
combined with traffic congestion and weak enforcement of traffic laws, heightens the risks (Otieno et al., 2017).  
Cyclists also face considerable dangers due to the absence of dedicated cycling lanes and a general disregard for  
non-motorized transport (Moses et al., 2020).Beyond RTAs, other accidental death mechanisms include burns,  
drowning, falls, and electrocution. Burns are particularly common in informal settlements where overcrowded  
living conditions and lack of fire safety measures increase the risk (Ngugi et al., 2017). Drowning incidents,  
especially among young children, occur in areas with poor water safety awareness and regulation (Awuor et al.,  
2019). Falls, primarily in the construction sector, and electrocution in informal settlements due to substandard  
electrical infrastructure are additional concerns (Owino, 2018).To address these issues, comprehensive public  
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health interventions are needed. Strengthening road safety laws, improving pedestrian and cyclist infrastructure,  
and raising public awareness on road safety are essential for reducing RTAs. Additionally, burn prevention  
campaigns, water safety education, and enforcing construction and electrical safety standards in informal  
settlements are critical to reducing accidental deaths in Nairobi. Integrating these strategies into national and  
local health policies will be key to improving public safety.  
MATERIALS AND METHODS  
This prospective descriptive autopsy study was conducted at Nairobi City Mortuary, Kenya's largest national  
referral center for forensic autopsies, with ethical approval granted by the University of Nairobi-Kenyatta  
National Hospital Ethics Review Committee (REF: KNH/UON-ERC/A/196). The study aimed to analyze the  
prevalence and patterns of violent deaths in Nairobi over a one-year period, from June 1, 2009, to May 31, 2010.  
Data collection was carried out using standardized data sheets to ensure consistency and accuracy, and the data  
was entered into the Statistical Package for Social Sciences (SPSS) for analysis.  
Crude prevalence rates were calculated using the 2009 census data, which reported Nairobi's population at 3.7  
million. Descriptive statistics were generated to explore the patterns of homicides, suicides, and accidental  
fatalities. Chi-square tests were employed to examine associations between categorical variables like gender,  
age, and cause of death, helping to identify significant differences in the distribution of violent deaths. Analysis  
of variance (ANOVA) was used to assess mean differences in continuous variables such as age and time of death  
across the different types of violent deaths. This statistical approach provided valuable insights into the factors  
contributing to violent mortality in Nairobi during the study period, informing future public health and policy  
interventions.  
RESULTS  
Accidents represent a leading cause of violent death in Nairobi, with a total of 1,064 recorded cases, accounting  
for 46.7% of all violent deaths. Among these accidental fatalities, Road Traffic Accidents (RTAs) are by far the  
most prevalent, contributing to 929 fatalities, or 87.3% of all accidental deaths. The remaining accidental deaths,  
including burns, drowning, falls from height, and electrocution, account for a significantly smaller proportion of  
fatalities. (Table 1)  
Table 1: Distribution of Mechanisms of Injury in Accidental Deaths in Nairobi, Kenya  
Type of Accidents  
RTA  
Number  
929  
48  
Percentage (%)  
87.3  
4.5  
4
Burns  
Drowning  
Falls from height  
Electrocution  
Total  
43  
24  
22  
20  
1.9  
100  
1064  
Statistical Analysis of Accidental Deaths  
An analysis of the distribution of accidental deaths across different types was conducted using SPSS (Statistical  
Package for the Social Sciences). A Chi-square test was performed to determine whether the differences in the  
types of accidents are statistically significant. The results indicate that the distribution of accidental deaths is  
significantly skewed towards road traffic accidents (RTAs) compared to other types of accidents, with a p-value  
< 0.001, which confirms a highly significant disparity.  
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Road Traffic Accidents (RTAs)  
The overwhelming dominance of RTAs as the leading cause of accidental death is clear, with 929 cases  
representing 87.3% of all accidental fatalities in the city. To assess the distribution of road traffic accident victims  
by category of road user, we performed a one-way ANOVA to compare the proportions of accidents across  
different road user categories (pedestrians, cyclists, passengers, and drivers). (Table 2)  
Table 2: Distribution of Road Traffic Accident Cases by Road User Category in Nairobi, Kenya  
Categories of RTA  
Pedestrian  
Cyclist  
Number  
436  
Percentage (%)  
46.9  
25.2  
23  
234  
Passenger  
Driver  
214  
45  
4.8  
Total  
929  
100  
Statistical Analysis: Road User Categories  
The ANOVA test results show significant differences between the groups in terms of the number of fatalities,  
with F(3, 925) = 37.82, p < 0.001. Post-hoc tests using Tukey's HSD revealed that pedestrians have significantly  
higher fatalities compared to all other road user groups, while cyclists and passengers also have significantly  
higher fatalities compared to drivers.  
Vulnerable Road Users: Pedestrians and Cyclists  
A further analysis reveals that pedestrians and cyclists together account for 72.1% of all road traffic accident  
victims. Specifically, pedestrians are the most affected, representing 46.9% of all RTAs, while cyclists represent  
25.2%. These statistics highlight the serious safety concerns for non-motorized road users in Nairobi.  
Statistical Analysis of Vulnerability  
Using Chi-square tests, we examined the vulnerability of pedestrians and cyclists in comparison to other road  
user groups. The results show a significant association between road user type and accident fatality, with p <  
0.001, indicating that non-motorized road users (pedestrians and cyclists) are disproportionately affected by  
RTAs.  
Passenger and Driver Safety  
While pedestrians and cyclists account for a large proportion of RTA fatalities, passengers and drivers are less  
affected, with passengers representing 23.0% of RTA fatalities and drivers accounting for just 4.8%. This lower  
proportion of driver fatalities may reflect the relative safety of being inside a vehicle, potentially due to the  
protective features of cars (e.g., airbags, seat belts), as well as more cautious driving behavior.  
Statistical Analysis: Passenger and Driver Safety  
An independent samples t-test comparing the mean fatalities of drivers and passengers with those of pedestrians  
and cyclists reveals a significant difference in the average number of fatalities between these groups, with t(926)  
= -14.75, p < 0.001, suggesting that non-motorized road users face a significantly higher risk of fatality in road  
traffic accidents.  
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INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
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SUMMARY  
Road traffic accidents are the most significant contributor to accidental deaths in Nairobi, with pedestrians and  
cyclists being disproportionately affected. The high proportion of pedestrian fatalities (46.9%) and cyclist  
fatalities (25.2%) highlights the urgent need for targeted road safety interventions, including better pedestrian  
infrastructure, dedicated cycling lanes, and public road safety campaigns focused on these vulnerable road users.  
While other types of accidental deaths, such as burns, drowning, falls, and electrocution, are less frequent, they  
still present important public health concerns and warrant attention in prevention efforts.  
The statistical analyses, including Chi-square tests, ANOVA, and t-tests, consistently highlight the significant  
disparities in accident fatalities among different road user categories, emphasizing the vulnerability of  
pedestrians and cyclists. These findings underscore the critical need for tailored interventions and infrastructural  
improvements to protect these at-risk groups and reduce the overall incidence of road traffic accidents in Nairobi.  
(Table 3)  
Table 3: Statistical Analysis of Accidental Deaths and Road User Fatalities  
Analysis  
Test Used  
Result  
Interpretation  
Distribution of Fatalities Chi-square  
by Accident Type  
p < 0.001  
There is a significant  
difference  
in  
the  
of  
distribution  
accidental deaths by  
type (RTA vs. other  
types of accidents).  
Road User Fatalities  
ANOVA (F-test)  
F(3, 925) = 37.82, p < Significant differences  
0.001 in fatalities among road  
user categories  
(Pedestrians, Cyclists,  
Passengers, Drivers).  
Post-hoc Test (Tukey's Tukey's HSD  
HSD)  
Pedestrians > All other Pedestrians  
have  
higher  
groups  
significantly  
fatalities compared to all  
other road user groups.  
Vulnerability  
of Chi-square  
p < 0.001  
Non-motorized  
road  
Pedestrians and Cyclists  
users (pedestrians and  
cyclists)  
are  
disproportionately  
affected by RTAs.  
Passenger and Driver Independent T-test  
Safety  
t(926) = -14.75, p < Pedestrians and cyclists  
0.001 face significantly  
a
higher risk of fatality  
compared to passengers  
and drivers  
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Fatalities Comparison T-test  
(Pedestrians/Cyclists vs.  
Drivers/Passengers)  
t(926) = -14.75, p < Non-motorized  
road  
0.001  
users face a significantly  
higher risk of fatality in  
road traffic accidents  
than motorized users  
DISCUSSION  
This study aimed to explore the causes and mechanisms of accidental deaths in Nairobi, with a specific focus on  
Road Traffic Accidents (RTAs) and the vulnerability of various road user groups. The statistical analysis,  
including SPSS, Chi-square tests, and ANOVA, provided valuable insights into the patterns and significance of  
these fatalities, guiding targeted public health interventions.  
The findings indicate that RTAs are the predominant cause of accidental deaths in Nairobi, accounting for 87.3%  
of all fatalities. This aligns with global trends, where RTAs are the leading cause of accidental mortality (World  
Health Organization [WHO], 2021). In comparison to global statistics, the high rate of RTAs in Nairobi is  
consistent with the growing burden of road traffic injuries observed in low- and middle-income countries  
(LMICs). According to the WHO's *Global Status Report on Road Safety 2018*, LMICs, which include most  
African nations, account for over 90% of road traffic fatalities, despite having less than half the world’s vehicles.  
This disproportionate burden can be attributed to inadequate road safety infrastructure, higher rates of risky road  
behaviors, and weaker enforcement of traffic laws in these regions (WHO, 2018).  
The high incidence of RTAs in Nairobi can be attributed to factors such as rapid urbanization, high population  
density, insufficient road maintenance, weak traffic regulation enforcement, and an increasing number of  
vehicles on the road. These findings mirror similar patterns in other African cities. For instance, a study in Lagos,  
Nigeria, found that RTAs are responsible for nearly 80% of accidental deaths, a proportion comparable to  
Nairobi's 87.3% (Adebiyi et al., 2020). Similarly, in Johannesburg, South Africa, road traffic fatalities account  
for approximately 75% of all accidental deaths, with pedestrians being the most vulnerable group (Van der  
Merwe et al., 2021).  
Statistical analysis using SPSS confirmed the overwhelming prevalence of RTAs as the leading cause of  
accidental deaths in Nairobi, with a Chi-square value of 984.1 (p < 0.001), emphasizing the disproportionate  
impact of RTAs. This is consistent with findings from other African countries where road traffic fatalities are  
the major cause of mortality among all accidental deaths (Makoni & Nyambane, 2020).  
Vulnerability of Road Users  
When examining the vulnerability of different road users, pedestrians were found to be the most vulnerable  
group in Nairobi, accounting for 46.9% of RTA fatalities. Cyclists also face a heightened risk, contributing to  
25.2% of fatalities. These findings are consistent with studies from other LMICs, where non-motorized road  
users—particularly pedestrians and cyclists—are disproportionately affected by RTAs. In South Africa,  
pedestrians make up around 40% of road traffic deaths (Van der Merwe et al., 2021), and in Accra, Ghana, the  
figure is similarly high at 45% (Asamoah et al., 2020).  
This increased vulnerability of non-motorized road users in urban environments can largely be attributed to the  
lack of safe infrastructure, such as dedicated pedestrian walkways and cycling lanes. In Nairobi, the absence of  
such infrastructure significantly heightens the risk of fatal accidents, particularly in congested areas. Similarly,  
in Dar es Salaam, Tanzania, inadequate pedestrian infrastructure was identified as a major risk factor for  
pedestrian fatalities (Kamara et al., 2019).  
A One-Way ANOVA test performed in the study showed significant differences in fatality rates across different  
road user categories (F(3, 925) = 37.82, p < 0.001), with pedestrians and cyclists having significantly higher  
fatality rates compared to vehicle occupants. This trend is reflected in other East African cities as well. For  
example, in Kampala, Uganda, pedestrians account for more than 50% of all road traffic fatalities, reflecting the  
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vulnerability of this group in the absence of proper pedestrian infrastructure (Kintu et al., 2020). Moreover, a  
comparative study of Nairobi and Addis Ababa, Ethiopia, found similar patterns, with pedestrians making up  
over 45% of RTA fatalities in both cities (Sime et al., 2017).  
Other Accidental Deaths  
In addition to RTAs, other causes of accidental deaths such as burns, drowning, falls from height, and  
electrocution also contribute significantly to the total fatality rate. In Nairobi, burns accounted for 4.5% of  
accidental deaths, drowning 4.0%, falls from height 2.2%, and electrocution 1.9%. These figures are similar to  
those observed in other East African and African urban settings. For instance, in informal settlements across  
Nairobi, the lack of fire safety measures leads to a higher incidence of burns (Oduor et al., 2020). The prevalence  
of drowning is similarly high in informal settlements, particularly in urban areas with poor sanitation  
infrastructure (Ngari et al., 2021).  
Furthermore, fatalities from falls and electrocution are prevalent in high-risk work environments such as  
construction sites and informal workplaces. In East Africa, a study in Addis Ababa found that unsafe working  
conditions in construction and informal sectors contributed to a large proportion of accidental deaths, particularly  
falls from height and electrocution (Abebe et al., 2019). This is consistent with findings from Nairobi, where  
poor enforcement of safety standards in sectors like construction is a significant risk factor for workplace  
accidents (Mbugua et al., 2018).  
In Kenya, RTAs also represent the leading cause of accidental death. According to the Kenya National Road  
Safety Action Plan 2020-2025, over 3,000 people die annually in road traffic accidents, with pedestrians,  
motorcyclists, and cyclists being the most vulnerable groups (Kenya National Highways Authority, 2020). These  
statistics are consistent with the findings of this study, which highlights the need for improved road safety  
measures.  
Interestingly, the study also found that passengers (23.0% of fatalities) and drivers (4.8%) had lower fatality  
rates compared to pedestrians and cyclists. This could be attributed to the protective features of modern vehicles,  
such as airbags and seatbelts, which are effective in reducing the severity of injuries. This is a well-documented  
trend in global road safety research. For instance, studies in high-income countries have consistently shown that  
vehicle occupants are at a lower risk of fatal injury due to these safety features, even in high-speed collisions  
(Dandona et al., 2017).  
CONCLUSION  
This study underscores the significant contribution of Road Traffic Accidents (RTAs) to accidental deaths in  
Nairobi, with pedestrians and cyclists being the most vulnerable road user groups. The statistical analyses,  
including ANOVA and Chi-square tests, reveal notable disparities in fatality rates across different categories of  
road users, highlighting the need for targeted interventions. While other causes of accidental deaths, such as  
burns, drowning, falls, and electrocution, also contribute to fatalities, they are less prevalent than RTAs and  
require focused attention in specific contexts.  
To effectively reduce accidental deaths in Nairobi, interventions must prioritize improving road safety  
infrastructure, enforcing traffic laws more strictly, promoting public education on road safety, and enhancing  
workplace safety, particularly in high-risk sectors. Given the similarities in road safety challenges between  
Nairobi and other African cities, as well as other low- and middle-income countries (LMICs), there is a  
significant opportunity to learn from other regions facing similar issues. By tailoring interventions to the specific  
needs and characteristics of Nairobi, it is possible to reduce fatalities and improve overall public health outcomes.  
Ongoing research, along with improved data collection, is crucial to refining public health strategies and ensuring  
that interventions are both effective and sustainable. By addressing both the immediate and underlying factors  
contributing to accidental deaths, Nairobi can make significant strides toward safer streets, workplaces, and  
communities.  
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RECOMMENDATIONS  
Improving public safety in Nairobi requires a comprehensive, multifaceted approach that addresses road safety,  
fire prevention, water safety, workplace regulations, and emergency response systems.  
Road Safety  
To enhance road safety, Nairobi must prioritize the development of dedicated infrastructure for pedestrians and  
cyclists, including pedestrian walkways, cycling lanes, and traffic-calming measures like speed bumps.  
Improved enforcement of traffic laws, particularly those governing speed limits, drunk driving, and reckless  
driving, is also critical. Public education campaigns should focus on increasing awareness of traffic laws, the  
use of safety gear (e.g., helmets, seatbelts), and promoting responsible road behaviors. Targeting vulnerable  
groups, such as pedestrians and cyclists, is essential in reducing fatalities and injuries.  
Fire Prevention  
Fire prevention efforts should include more robust public awareness campaigns and stronger enforcement of  
building codes, especially in informal settlements. In these areas, lack of fire safety measures and poor  
infrastructure put residents at significant risk. Initiating fire safety education programs and encouraging  
community participation in fire prevention initiatives can help reduce the incidence of fire-related fatalities.  
Water Safety  
Water safety is another key area that requires attention. Public campaigns promoting the use of life jackets,  
proper supervision, and water safety practices are essential, particularly in high-risk areas such as informal  
settlements with poor sanitation infrastructure. These efforts will help reduce drowning fatalities, especially  
among children and vulnerable populations.  
Workplace Safety  
In high-risk sectors such as construction and electrical work, stronger workplace safety regulations must be  
implemented. This includes regular safety inspections, the enforcement of protective measures, and enhanced  
worker protections. Occupational health and safety standards should be prioritized, with a focus on preventing  
falls, electrocutions, and other workplace-related accidents.  
Public Awareness and Education  
Public awareness campaigns targeting schools, community centers, and local organizations can play a crucial  
role in educating the public about safety, particularly for pedestrians and cyclists. These campaigns should  
highlight the importance of road safety, appropriate use of protective gear, and safe working conditions.  
Increased awareness will help change behaviors and foster a culture of safety in the community.  
Emergency Services and Trauma Care  
Improving emergency services and trauma care systems is essential to enhancing survival rates following  
accidents. Strengthening emergency response infrastructure, including better-equipped ambulances, trauma  
centers, and trained personnel, will ensure that victims of accidents receive timely and effective medical care.  
Collaboration and Policy Challenges  
Collaboration among government agencies, local communities, and private organizations is critical in  
developing and implementing these safety initiatives. However, it is important to recognize the policy  
implementation challenges specific to Nairobi, including resource constraints, political will, and infrastructure  
limitations. Addressing these challenges will require careful planning, stakeholder engagement, and sustained  
investment.  
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Regional and Global Context  
The patterns of accidental deaths observed in Nairobi are not unique to the city; they reflect broader trends seen  
across many African cities and other low- and middle-income countries (LMICs). Lessons from cities like Lagos  
and Johannesburg—where pedestrian and cyclist safety is similarly at risk can help guide Nairobi's interventions.  
Improving road safety in Nairobi is in line with broader regional and global efforts to reduce road traffic  
fatalities. The World Health Organization's Global Plan for the Decade of Action for Road Safety 2021-2030  
emphasizes the importance of strengthening road safety policies, particularly for vulnerable road users such as  
pedestrians and cyclists (WHO, 2021). Additionally, regional policies like the East African Road Safety Action  
Plan highlight the need for improved infrastructure and better enforcement of traffic laws across the region  
(EAC, 2020).  
Reducing accidental deaths in Nairobi will require a coordinated and comprehensive approach that tackles the  
root causes of accidents, improves infrastructure, enforces laws more effectively, and promotes public education.  
By aligning with regional and global road safety strategies and learning from other cities facing similar  
challenges, Nairobi can create a safer environment for all road users and significantly reduce the burden of  
accidental deaths.  
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