Children and young adults (adolescents) are particularly vulnerable to inflicted and accidental fatal injuries. [1,2] The United Nations Children's Fund (UNICEF) convention on the right of the child defines a child as 'a person below the age of 18, unless the laws of a particular country set the legal age for adulthood younger'. [3] According to Statistics South Africa (SA) (2008), [4] the leading underlying natural cause of death in children <14 years of age was intestinal infectious diseases (21.8% of deaths), followed by influenza and pneumonia-collectively accounting for a third of deaths in this age group. HIV/AIDS is a leading cause of mortality, with a prevalence rate of 10.6% in SA in 2009, and an estimated 5.21 million people living with the disease. [5,6] Individuals aged between 15 and 24 years are recorded as having the highest incidence of the disease. In SA, the age group 15-49 years is most at risk for non-natural deaths, with 13.9% of deaths in this group being non-natural and the most common circumstance/external cause of death interpersonal violence (assault). [4] The high incidence of child fatalities due to road traffic accidents has been well documented worldwide. In San Diego, Fraga et al. [1] reported (in their study conducted at the medico-legal mortuary) that road traffic fatalites were the leading cause of accidental death (40.2% of cases). In Nebraska, Okoye and Okoye [7] reviewed medico-legal childhood deaths over a 7-year period and reported motor vehicle accidents as the cause of death in 23.6% of cases. In Brazil, Modelli et al., [8] reporting on deaths in children <12 years, found the leading external cause of death to be road traffic fatalities (22% of cases). In Nigeria, Nwafor et al. [9] reviewed deaths in children ≤14 years; in a 20-year period, road traffic accidents accounted for 74.6% of accidental deaths and 15.4% of total deaths. In SA, Bass et al. [10] reviewed children <14 years who presented to Red Cross War Memorial Children's Hospital in Cape Town. They indicated that 430 children were involved as pedestrians in accidents over a 12-month period, with 106 fatalities. Deaths due to asphyxia in children was the second most common cause of death in the study by Fraga et al., [1] accounting for 22.7% of cases. Okoye and Okoye [7] indicated asphyxia mainly in children <5 years, with a total of 22 (15.7%) cases, and 7 (5%) cases of drowning. Modelli et al. [8] indicated asphyxia in 17% of cases. Homicides in children <18 years accounted for 24.2% of deaths in San Diego, [1] 5% in Nebraska, [7] 1.5% in Nigeria, [9] and 13% in Istanbul. [11] Suicide in children accounted for 9.4% of deaths in San Diego, [1] 13.6% in Nebraska, [7] and 7.4% in the Istanbul study. [11] Cases due to natural causes on completion of the medico-legal investigation of death and that were admitted to the medico-legal mortuaries mentioned in the abovementioned studies accounted for 30% of deaths in the Okoye and Okoye [7] study, 50% in the Modelli et al. [8] study, 77.5% in the Nwafor et al. [9] study, ...
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