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      Patterns of blunt force homicide in the West Metropole of the City of Cape Town, South Africa

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          Abstract

          There is currently a lack of information regarding the prevalence of and characteristics associated with blunt force trauma related homicides in South Africa. Information relating to the patterns of blunt force trauma could assist in the development and implementation of interventions targeted at specific areas or individuals as well as direct future research towards areas in need of investigation. This study is a 5-year retrospective review of autopsy reports obtained from Salt River Mortuary (Cape Town, South Africa). The prevalence of blunt force trauma was considered for unnatural deaths with a focus on homicide. The patterns of homicidal blunt force trauma are also presented. A total of 15 519 autopsy cases was analysed. In 1198 (7.72%) of these cases, the cause of death was found to be blunt force trauma and 828 (5.32%) of these cases were classified as homicides. Approximately 11% of blunt force homicide cases occurred in combination with sharp and/or ballistic trauma. Men from poor socio-economic areas were shown to be most at risk of blunt force homicide in the City of Cape Town. SIGNIFICANCE: • The prevalence of homicidal blunt force trauma in the Western Metropole of the City of Cape Town is comparable to other regions in South Africa. • The vast majority of victims sustained injury to the head, highlighting the need for further research in cranial blunt force trauma. • Interventions should target young men, particularly in low socio-economic regions.

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          Violence and injuries in South Africa: prioritising an agenda for prevention.

          Violence and injuries are the second leading cause of death and lost disability-adjusted life years in South Africa. The overall injury death rate of 157.8 per 100,000 population is nearly twice the global average, and the rate of homicide of women by intimate partners is six times the global average. With a focus on homicide, and violence against women and children, we review the magnitude, contexts of occurrence, and patterns of violence, and refer to traffic-related and other unintentional injuries. The social dynamics that support violence are widespread poverty, unemployment, and income inequality; patriarchal notions of masculinity that valourise toughness, risk-taking, and defence of honour; exposure to abuse in childhood and weak parenting; access to firearms; widespread alcohol misuse; and weaknesses in the mechanisms of law enforcement. Although there have been advances in development of services for victims of violence, innovation from non-governmental organisations, and evidence from research, there has been a conspicuous absence of government stewardship and leadership. Successful prevention of violence and injury is contingent on identification by the government of violence as a strategic priority and development of an intersectoral plan based on empirically driven programmes and policies.
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            The high burden of injuries in South Africa

            OBJECTIVE To estimate the magnitude and characteristics of the injury burden in South Africa within a global context. METHODS: The Actuarial Society of South Africa demographic and AIDS model (ASSA 2002) - calibrated to survey, census and adjusted vital registration data - was used to calculate the total number of deaths in 2000. Causes of death were determined from the National Injury Mortality Surveillance System profile. Injury death rates and years of life lost (YLL) were estimated using the Global Burden of Disease methodology. National years lived with disability (YLDs) were calculated by applying a ratio between YLLs and YLDs found in a local injury data source, the Cape Metropole Study. Mortality and disability-adjusted life years' (DALYs) rates were compared with African and global estimates. FINDINGS: Interpersonal violence dominated the South African injury profile with age-standardized mortality rates at seven times the global rate. Injuries were the second-leading cause of loss of healthy life, accounting for 14.3% of all DALYs in South Africa in 2000. Road traffic injuries (RTIs) are the leading cause of injury in most regions of the world but South Africa has exceedingly high numbers - double the global rate. CONCLUSION: Injuries are an important public health issue in South Africa. Social and economic determinants of violence, many a legacy of apartheid policies, must be addressed to reduce inequalities in society and build community cohesion. Multisectoral interventions to reduce traffic injuries are also needed. We highlight this heavy burden to stress the need for effective prevention programmes.
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              Epidemiology of violent deaths in the world.

              This study describes epidemiologic patterns of mortality due to suicide, homicide, and war for the world in order to serve as a benchmark against which to measure future progress and to raise awareness about violence as a global public health problem. The world and its eight major regions. Data were derived from The Global Burden of Disease series and the US National Center for Health Statistics to estimate crude rates, age adjusted rates, sex rate ratios, and the health burden for suicide, homicide, and war related deaths for the world and its eight major regions in 1990. In 1990, an estimated 1,851,000 people died from violence (35.3 per 100,000) in the world. There were an estimated 786,000 suicides. Overall suicide rates ranged from 3.4 per 100,000 in Sub-Saharan Africa to 30.4 per 100,000 in China. There were an estimated 563,000 homicides. Overall homicide rates ranged from 1.0 per 100,000 in established market economies to 44.8 per 100,000 in Sub-Saharan Africa with peaks among males aged 15-24 years old, and among females aged 0-4 years old. There were an estimated 502,000 war related deaths with peaks in rates for both sexes among people aged 0-4, 15-29, and 60-69 years old. The number of violence related deaths in the world is unacceptably high. Coordinated prevention and control efforts are urgently needed.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                sajs
                South African Journal of Science
                S. Afr. j. sci.
                Academy of Science of South Africa (Pretoria, Gauteng, South Africa )
                0038-2353
                1996-7489
                June 2017
                : 113
                : 5-6
                : 1-6
                Affiliations
                [01] Cape Town orgnameUniversity of Cape Town orgdiv1Department of Pathology, Division of Forensic Medicine and Toxicology South Africa
                Article
                S0038-23532017000300012
                10.17159/sajs.2017/20160214
                e350900c-349c-4ed0-b415-8c4514c1d57c

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 July 2016
                : 11 November 2016
                : 29 September 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 6
                Product

                SciELO South Africa


                blunt force trauma,pattern of injuries,autopsy,fracture,laceration

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