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43 ICECI: injury surveillance in South Africa
  1. Richard Matzopoulos
  1. University of Cape School of Public Health/South African Medical Research Council Burden of Disease Research Unit


Background South Africa is a middle income country with large disparities in wealth and has one of the world’s highest rates of injury mortality; more than half are from intentional injuries, particularly violence a major problem in the Western Cape Province. Injuries claim 450 lives each month. Homicide was the third leading contributor to premature mortality in 2010.

Description of the problem Reliable mortality and morbidity data are vital for estimating Burden of Disease accurately and directing resources for injury prevention and control. This poses a particular challenge in low-income countries, which experience high rates of injury, particularly if these injuries are concentrated at peak times, overwhelming emergency treatment centres and displacing patients seeking treatment for other conditions.

Results The Western Cape has implemented a province-wide mortality surveillance system, the Provincial Injury Mortality Surveillance System that provides complete coverage of injury-related deaths. There are several trauma registries in tertiary hospitals and intermittent cross-sectional studies in all facilities serving selected high-risk areas.

This overview describes methodological aspects, including the use of separate coding axes for key variables akin to an ICECI structure, which simplifies data capture, before data are coded to either ICD-10 or Burden of Disease categories.

The results demonstrate the utility of the surveillance data in identifying high-risk areas and groups at-risk. Data collection has been co-ordinated by the Health Department in collaboration with injury prevention researchers and the instutionalisation of all except the mortality component represents a key challenge for ongoing surveillance.

Conclusions The data have been instrumental in providing ongoing burden of disease estimates for the province and complementing national burden of disease studies, evaluating interventions such as alcohol and gun control, and influencing prevention and interpersonal violence and alcohol harm reduction policies.

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