Injury mortality in rural South Africa 2000 – 2007: rates and associated factors*

Abstract

ObjectiveTo estimate injury mortality rates in a rural population in KwaZulu-Natal, South Africa and to identify socio-demographic risk factors associated with adult injury-related deaths.MethodsThe study used population-based mortality data collected by a demographic surveillance system on all resident and non-resident members of 11 000 households. Deaths and person-years of observation (pyo) were aggregated for individuals between 01 January 2000 and 31 December 2007. Cause of death was determined by verbal autopsy, coded using ICD-10 and further categorised using global burden of disease categories. Socio-demographic risk factors associated with injuries were examined using regression analyses.ResultsWe analysed data on 133 483 individuals with 717 584.6 person-years of observation (pyo) and 11 467 deaths. Of deaths, 8.9% were because of injury-related causes; 11% occurred in children <15 years old. Homicide, road traffic injuries and suicide were the major causes. The estimated crude injury mortality rate was 142.4 (134.0, 151.4)/100 000 pyo; 116.9 (108.1, 126.5)/100 000 pyo among residents and 216.8 (196.5, 239.2)/100 000 pyo among non-residents. In multivariable analyses, the differences between residents and non-residents remained but were no longer significant for women. In men and women, full-time employment was significantly associated with lower mortality [adjusted rate ratios 0.6 (0.4, 0.9); 0.4 (0.2, 0.9)]; in men, higher asset ownership was independently associated with increased mortality [adjusted rate ratio 1.5 (1.1, 1.9)].ConclusionsReducing the high levels of injury-related mortality in South Africa requires intersectoral primary prevention efforts that redress the root causes of violent and accidental deaths: social inequality, poverty and alcohol abuse.

Risk factors for injury mortality in rural Tanzania: a secondary data analysis

“…This compares with the study by Garrib et al, 21 which found that full-time employment was significantly associated with lower mortality in South Africa.…”

“…Studies have shown that Africa had the highest drowning death rate (13.1/100 000 PYO) and men had higher drowning death rates than women for all ages and in all regions and was more pronounced in children up to 14 years. 7 In this study, however, most of the drowning fatalities occurred in young (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) and middle-aged (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) adults. In the Rufiji DSA, most of the people are engaged in subsistence farming and fishing activities with the proximity of the Rufiji River as a possible influencing factor.…”

“…11 30 31 Death rates because of road traffic crashes were again significantly higher in men than women in all age groups, for both pedestrians and vehicle occupants. 21 Many other factors are known to be associated with risk of injury mortality. These include poverty, lack of education, unemployment, alcohol and substance abuse, interpersonal conflict, intimacy and power.…”

“…40 In another study, higher death rates were reported for homicide deaths among men in all age groups especially young adults aged 30-39 years. 21 In related studies, young adult men are at the highest risk of injury-related mortality and comprised the majority of perpetrators as well as victims of interpersonal violence. 33 41 Suicide was the lowest rate of external cause of death in this community even though suicide was the most common cause of injury death and was more pronounced in men compared with women in a South African study.…”

Childhood unintentional injuries: Supervision and first aid provided

“…Caregivers tend to overestimate the ability of their children to act safely in traffic-for instance the ability to cross roads by themselves-but under the age of six, children are neurodevelopmentally immature and do not possess the ability and skills to adequately assess environmental dangers. [6,7,22] Community-based prevention programs are essential and should be put into practice through churches, community centres and other communal institutions to teach parents and caregivers about these topics. [22] Substance abuse was denied in all cases.…”