Objectives To conduct a community survey to estimate the degree to which road traffic injuries (RTIs) are under reported and to compare the characteristics of RTI reported to the police to those not reported.

Design A cross-sectional population-based study.

Setting Kandy district, Sri Lanka.

Participants RTIs and deaths during the preceding 12 months were identified through a community-based cross-sectional survey with a sample size of 3080 households. A stratified multistage cluster sampling with population proportion to size was used. ‘Events reported’ to the police were cross checked against events in the police records of the given or adjacent police stations, and either were ‘Events found’ or ‘Not found’. ‘Under reported’ included those ‘Not reported’ and those reported but ‘Not found’ in the police dataset.

Results Information about 11 724 persons were obtained from 3080 households, identifying 149 persons who suffered an RTI. Of these, 57% were ‘Events reported’, and of these 43.6% (n=65) were ‘Events found’ in police records (95% CI, 36.0 to 51.6). There were 42 events ‘Not reported’ to police while an additional 7 were ‘Not found’ in the police records of the given police station. Although they were claimed to have been reported to the police, 33% (95% CI 25.8 to 40.7) were ‘Under reported’. There were significant differences in age (p=0.02), family income (p<0.001), road user type (p=0.001), injury severity (p<0.001) and injury category (p=0.01) between ‘Events found’ in the police records and ‘Under reported’ events.

Conclusions In the Kandy district, 33% of RTIs were ‘under reported’. These findings could be used as evidence for policy planning to prevent RTIs, and highlights the need for a nation-wide community-based survey to determine the true rates of RTI for a better understanding of the reasons for under reporting.