Nowadays, more and more people have access to a mobile phone and  use  the  services  associated  with  it, both in high-income countries and in low- and middle-income   countries.   It   is   estimated   that   about  three- quarters of the world's population had access to mobile phones in 2017 (International Telecommunication Union, 2018). Like other African countries, Benin is witnessing a widespread use of mobile phones by all segments of the population. In 2017, the number of active mobile telephone subscribers was estimated at around 8.8 million, for a population of nearly 11.2 million (Autorité de Régulation des Communications Electroniques et de la Poste, 2018). As the number of mobile phone holders increases, their use in places other than home or service such as in vehicles is also increasing. In this context, it is now common to observe road users using their phones to make or answer calls, consult or even write messages, or even seek information; this despite the risks that such behaviour could induce in terms of road safety. According to the World Health Organization (WHO), drivers who use their mobile phones while riding are four times more likely than others to be involved in a road accident (RA) (Organisation Mondiale de la Santé, 2019). A meta-analysis of 33 studies also indicate that telephone use while riding increases driver reaction time by an average of 0.25 s (Caird et al., 2008). Mobile phone use while riding concerns both users of four-wheeled vehicles and users of two-wheeled motorized vehicles. The situation of users of two-wheeled vehicles is more worrying because the stability of the vehicle is less guaranteed, and in the event of crash, the driver has no physical protection.

In Benin, road transport is characterized by a high use of two-wheeled motor vehicles and the emergence for several years of professional motorcyclists, motorcycle taxis (a mode of public transport of people and/or goods by means of a motorcycle) which today represent the main part (75%) of transport services, particularly in the city of Cotonou (Djossou, 2014). The Professional Motorcyclist (PM) who uses his telephone when riding is at high risk of road accidents and constitutes a danger to himself, his passenger and other road users. A better understanding of the extent of this behaviour among PMs and the factors associated with it is the first step in implementing interventions to reduce the phenomenon to contribute to the reduction of RAs and their consequences. This study, in order to help answer these key questions, aims to estimate the prevalence of telephone use while riding and identify the associated factors among PMs in Cotonou in 2019.

Study settings

The study was carried out in the city of Cotonou, the economic capital of Benin. The territory covers an area of 79 km² organized in 13 boroughs. Transport plays an important role in Cotonou, which is characterized by a concentration of most of the country’s economic activities and an agglomerate population of more than one million inhabitants. Transport enables ensuring that the internal traffic essential   for   the  supply  of  consumer  goods,  in  particular  food products and PM ensures a significant proportion of this traffic. The number of active PMs in Cotonou is estimated at 120,000 in 2017 according to statistics from the National Road Safety Centre (Centre National de Securité Routière, 2018).

Type of study, population and sampling

This was a cross-sectional study with an analytical focus and the data collection period extended from March 25 to April 19, 2019. A cluster sampling technique adapted from WHO were applied to select the PMs included in the study. The primary units were the PM parking lots while the secondary units were represented by the PMs registered at the level of the selected parks and who gave their free, written and informed consent to participate in the study. The minimum sample size calculated according to the Schwartz formula was 324 PM based on an expected prevalence of 50%, a cluster effect of 1.5 and a 10% increase to prevent non-response (Mendenhal et al., 2008).

Variables

The dependent variable was mobile phone use while riding. It was informed on the basis of a self-assessment and categorized into two modalities: "Yes" if a PM declared having access to a mobile phone and was used to using it (calling and/or sending SMS) when riding and "No" if a PM does not have access to a mobile phone or declared having a mobile phone and not used to using it when riding. The other variables retained were: (i) Socio-demographic characteristics: age (in years), sex, marital status (single or living alone/married or living with a partner), level of education (educated/uneducated), (ii) occupation-related variables: length of service (in years), type of driver (Permanent/Occasional), daily income (US dollars), possession of at least one type of riding license (Yes/No), history of RA as a PM (Yes/No), and (iii) other risk behaviors: alcohol consumption (Yes if the PM reported himself as a regular alcohol consumption/No).

Data collection, processing and analysis

The structured interview with a questionnaire was used for data collection. The data were entered with the Epi Info 7.2 software and analyzed under Stata/SE 15.1. Data analysis consisted of calculating weighted percentages for qualitative variables, weighted means and standard deviations for quantitative variables with normal distribution. The median and interquartile intervals were determined for quantitative variables that did not follow a normal distribution. A multivariate logistic model was used to identify the factors associated with mobile phone use while riding. In the multivariate analysis, only variables with a univariate p < 0.20 were introduced into a top-down step-by-step model to obtain adjusted estimates. The results were presented as Odds Ratio (OR) with their 95% confidence interval (CI95%). The level of significance has been set at 5%. The Hosmer-Lemeshow test was used to verify the adequacy of the final model.

Ethical statement

The study protocol was approved by the Institutional Review Board of Regional Institute of Public Health and was conducted with respect of confidentiality. The data collected from the targets were anonymous  and  confidential. They were collected individually after obtaining the free, written and informed consent of each MP surveyed. Prior to this, the targets received a detailed briefing note.

Four hundred and thirty (430) PMs were enrolled in this study. The average age of the targets were 38.44±0.42 years with extremes ranging from 20 to 60 years. No female PMs were included in this sample. Most PMs were educated and married. Nearly eight (8) out of ten (10) MPs had no other activity in parallel with their PM activity. It is also noted that about 90% of PMs generally earned less than 5,000 CFA francs (9 US dollars) per day. About 30% (95% CI: [26.17%; 35.00%]) of PMs reported a history of alcohol use. The median length of service of PMs was 5 years (3; 13). Nearly 27% of MPs have already been victim of an RA. In addition, nearly one-quarter of our targets had a driver's license with a predominance of a B license (Table 1).

Almost all (98.33%) of the PMs had a mobile phone. The prevalence of mobile phone use while riding was 12.47% (CI95%: [9.61% - 16.02%]). After multivariate analysis using the logistic regression model, we obtained a final model where alcohol consumption and length of service were significantly associated with mobile phone use while riding (Table 2). MPs who reported a history of alcohol use were 2.10 times more likely to use their mobile phones when riding their vehicles adjusted for length of service. MPs with ten (10) years or less of length of service were 2.20 times more likely to use their mobile phones while riding than those with more than 10 years of length of service who knew their alcohol consumption.

It appears that a relatively high proportion of PMs use their mobile phones when carrying out their professional activities. The situation is worrying given the importance of the PM sector in Benin in general and Cotonou in particular. These results should serve as a basis for advocacy for the development, adoption and enforcement of regulations on mobile phone use while riding. Primary prevention interventions must also be planned in order to best contribute to road safety and the improvement of the health status of populations.

The authors have not declared any conflict of interests.