Presented by Hilton Donson
SAFETY & PEACE PROMOTION
RESEARCH UNIT
National Injury Mortality
Surveillance System (NIMSS)
No...
 Staff and pathologists at participating MLLs and
Forensic Medicine departments.
 National and Provincial Departments of...
LEADING GLOBAL CAUSES OF DEATH, 2004 AND 2030
COMPARED
 Injuries are the 2nd leading cause of death and DALYs lost in
South Africa
 The overall injury death rate of 157.8 per ...
Females
Males
Source: South African Burden of Disease Study 2000
0
10000
20000
30000
40000
50000
60000
0
1–4
5–9
10–14
15–19
20–24
25–29
30–34
35–39
40–44
45–49
50–54
55–59
60–64
65–69
70...
History
 Established in 1999
 Includes all deaths due to external causes
 Based on information from existing medico-leg...
 Ongoing and systematic information about the
incidence, causes and consequences of all non-natural
deaths at all levels
...
Medico-legal
laboratory
management
tool
Capacity
Development
Media/public/
stakeholder
dissemination
Collaborative
Researc...
Nine participating medico
legal laboratories (MLLs) in
Gauteng
Descriptive findings in this
report are the result of an
au...
Violence, 3671,
32%
Suicide, 1278,
11%
Undetermined,
2195, 19%
Other Unintentional,
937,
8%
Transport, 3248,
29%
Other, 41...
Female, 
13.0%
Female,
15.8%
Female,
19.5%
Female,
26.7%
Female,
29.1%
Male, 87.0%
Male, 84.2%
Male, 80.5%
Male, 73.3%
Mal...
0%
10%
20%
30%
40%
50%
60%
70%
Percentageofcases
Age groups
Violence Suicide Transport Unintentional Undetermined
0 500 1000 1500 2000 2500 3000 3500 4000
Farm
Lake/river/dam
Industrial area
Medical service area
Railway
Open land
Inform...
0
50
100
150
200
250
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Numberofdeaths
Time of death
Violence S...
Zero
55.7%
0-4mg/100ml
4.4%
5-14mg/100ml
13.4%
15-
24mg/100ml
16.3%
25+mg/100ml
10.2%
0 500 1000 1500 2000
Passenger
MVA unspecified
Driver
Burns
Poisoning
Hanging
Blunt force
Sharp force
Pedestrian
Firearm
N...
Blood alcohol findings by apparent manner of death
Apparent manner
BAC's done
n(%)
BAC positive
n(%)
Mean
BAC
Std. Dev.
Vi...
Blood alcohol findings by transport user
Transport user
BAC's done
n(%)
BAC
positive
n(%)
Mean
BAC
Std. Dev.
Driver (542) ...
Year 2008 2009
Population# 7627922 7659017
Total deaths
Rate/ 100 000
pop.
Total deaths
Rate/ 100000
pop.
Violence 4223 51...
Mpumalanga South Africa
Violence 33.2 64.8
- firearm 9.6
- sharp object 10.7
Suicide 17.1 14
- firearm 2.1
- hanging 11.6
...
Mpumalanga South Africa
Transport 68.4
- road traffic 68.1 39.7
driver 19.4
pedestrian 20.9
passenger 21.3
Other
Unintenti...
 A permanent, nationwide system that registers all non-
natural deaths in South Africa
 Automated NIMSS
 Innovative
 F...
Thank You
Website:
MRC-UNISA Crime, Violence and Injury Lead Programme/Safety
and Peace Promotion Research Unit (SAPPRU)
h...
 Staff and pathologists at participating MLLs and
Forensic Medicine departments.
 National and Provincial Departments of...
A profile of non-natural deaths in Gauteng - Medical Research Council
A profile of non-natural deaths in Gauteng - Medical Research Council
A profile of non-natural deaths in Gauteng - Medical Research Council
A profile of non-natural deaths in Gauteng - Medical Research Council
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A profile of non-natural deaths in Gauteng - Medical Research Council

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  • The age-specific causes of death for males and females are presented in Figure. Infants andchildren under 5 suffered high numbers of deaths due to the unfinished agenda of infectious diseasesrelated to underdevelopment, and a high HIV/AIDS burden. HIV/AIDS deaths were also very high inyoung adult men and women, although the age pattern shows a 5 year later onset in men. Deaths dueto injuries were exceptionally high in adolescent and young adult men, and non-communicable causesof death were dominant in adults of 60 years and older.
  • THE GOALS OF THE NIMSS ARE:To provide ongoing and systematic information about the incidence, causes and consequences of all non-natural deaths at all levels.To enable the early identification of new injury trends and emerging problem areas so that adequate interventions can be timeously established. To determine priorities for injury and violence prevention action for high-risk groups and for socio-environmental risk factors. To help evaluate direct and indirect violence and injury prevention and control measures. To monitor seasonal and longitudinal changes in the non-natural death profile.
  • The ultimate goal of the NIMSS is to provide access to anyone and everyone who needs information on injury magnitude and patterns at national, provincial, city or other levels and to develop partnerships to inform initiatives for the prevention of these fatalities.
  • Table I shows the nine (out of ten) participating medico legal laboratories (MLLs) in Gauteng and the number of deaths recorded at each facility for 2009, including those from natural causes.  Not all cases had information for every item, and therefore totals in the subsequent graphs and tables may vary. Additionally, descriptive findings in this report (including charts and tables) are the result of an automated report generating process and hence, patterns emerging from some of the graphs with few cases should be interpreted with caution. Owing to the relatively few cases where date and time of injury were available, date and time of death have been reported instead. While death would have occurred at the time of injury for a majority of cases, some victims will have died hours or days after the injury itself, and this bias must be kept in mind when reading the relevant tables and charts.
  • Manner of death. Violence was the leading manner of death, accounting for just under one-third (32.4%, n= 3671) of the 11329 non-natural deaths recorded in Gauteng, followed by transport (28.7%, n=3248), suicide (11.3%, n=1 278), and other unintentional injury unintentional injuries (8.3%, n=937). For the remaining 2195 (19.4%) cases, the manner of death was undetermined.• 0-14 age group was undetermined (46.9%);• 15-24 age group was violence (41.5%);• 25-34 age group was violence (41.7%);• 35-44 age group was violence (34.9%) • 45-54 age group was transport (32.2%) • 55-64 age group was transport (32.4%); and• 65+ age group was transport (27.9%).
  • ENHR: Essential National Health Research Perhaps to mention DOH and FPS
  • The peak period(s) of death for:• violence was 20h00 - 01h00 (27.2%), 01h00- 03h00 (10.6%);• suicide was 17h00 - 20h00 (15.3%), 00h00 - 02h00 (11%), 09h00 - 11h00 (10.5%), 12h00 - 14h00 (10.1%), 07h00 - 08h00 (5.2%), 15h00 - 16h00 (5%);• transport related deaths was 18h00 - 00h00 (36.5%); and• other unintentional injury related deaths was 12h00 - 14h00 (11.2%), 01h00 - 02h00 (5.2%), 09h00 - 10h00 (5.2%), 19h00 - 20h00 (5.1%).
  • The peak days of death for:•violence were Saturdays (22.7%), Sundays(20.9%), and Fridays (13.1%);•suicide were Sundays(16.4%), Mondays (15.6%), and Wednesday (15.4%);•transport related deaths were Saturdays (20.5%), Sundays (19.6%), and Fridays (14.9%); and•other unintentional injury were Sundays (16.1%), Wednesdays (14.9%), and Tuesdays(14.5%).
  • All of the previous are in line with the broader mandate of SAPPRU, and importantly with that of the MRC, which is to ….- Optional, MRC mission: “To improve the nation’s health and quality of life through promoting and conducting relevant and responsive health research”
  • - Emphasise large impact on staffing and other resources > cannot be sustained without modifying the way the NIMSS is run at present > one way forward is automation of the NIMSS
  • The violence rate in Mpumalanga of 33.2 is however considerably lower than the reported overall South African rate of 64.8 per 100 000. The suicide rate in Mpumalanga of 17.1 per 100 000 is slightly higher than the average South African rate of 14 per 100 000.
  • The road traffic death rate of 68.4 per 100 000 in Mpumalanga is higher than the national estimate of 39.7 per 100 000 population, as reported by the latest available burden of disease estimates for South Africa.
  • The NIMSS would ideally be a permanent, nationwide system that will register all non-natural deaths that occur in South Africa. With the support of the forensic medicine departments and funding by UNISA, we believe we are moving in this direction with a new and innovative project, the Automated NIMSS System. It will be implemented in Mpumalanga and Gauteng, and the project is expected to conclude in 2011.
  • A profile of non-natural deaths in Gauteng - Medical Research Council

    1. 1. Presented by Hilton Donson SAFETY & PEACE PROMOTION RESEARCH UNIT National Injury Mortality Surveillance System (NIMSS) November 2010 A profile of non-natural death in Gauteng, 2009
    2. 2.  Staff and pathologists at participating MLLs and Forensic Medicine departments.  National and Provincial Departments of Health  State Forensic Pathology Services  Members of the NIMSS team
    3. 3. LEADING GLOBAL CAUSES OF DEATH, 2004 AND 2030 COMPARED
    4. 4.  Injuries are the 2nd leading cause of death and DALYs lost in South Africa  The overall injury death rate of 157.8 per 100 000 population is nearly twice the global average  Substantial burden of preventable mortality, physical and emotional disability, impacts on social and economic development, co-morbidity (HIV/AIDS, abuse of alcohol and illicit substances)
    5. 5. Females Males Source: South African Burden of Disease Study 2000
    6. 6. 0 10000 20000 30000 40000 50000 60000 0 1–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+ Natural deaths Non-natural deaths Statistics South Africa, 2009. Mortality and causes of death in South Africa, 2007: Findings from death notification, Pretoria: Statistics South Africa. Available at: www.statssa.gov.za. 44% 31% 17%
    7. 7. History  Established in 1999  Includes all deaths due to external causes  Based on information from existing medico-legal investigative procedures  Attempts to attempts to address gaps in information from existing systems, i.e. death notification and SAPS
    8. 8.  Ongoing and systematic information about the incidence, causes and consequences of all non-natural deaths at all levels  Identification of new injury trends and emerging problem areas  Priorities for injury and violence prevention action  Evaluate direct and indirect violence and injury prevention and control measures  Monitor seasonal and longitudinal changes in the non- natural death profile
    9. 9. Medico-legal laboratory management tool Capacity Development Media/public/ stakeholder dissemination Collaborative Research Interventions with partners Policy
    10. 10. Nine participating medico legal laboratories (MLLs) in Gauteng Descriptive findings in this report are the result of an automated report generating process – caution relatively few cases of date and time of injury were available, date and time of death have been reported instead While death would have occurred at the time of injury for a majority of cases, some victims will have died hours or days after the injury itself City MLL Total Bronkhorstspruit Bronkhorstspruit 317 Ekurhuleni Springs 1235 Heidelberg Heidelberg 291 Johannesburg Diepkloof 1738 Ekurhuleni Germiston 2678 Johannesburg Johannesburg 2531 Johannesburg Roodepoort 1409 Johannesburg Sebokeng 1376 Tshwane Ga-rankuwa 1155 Total 12 730
    11. 11. Violence, 3671, 32% Suicide, 1278, 11% Undetermined, 2195, 19% Other Unintentional, 937, 8% Transport, 3248, 29% Other, 4185, 37%
    12. 12. Female, 13.0% Female, 15.8% Female, 19.5% Female, 26.7% Female, 29.1% Male, 87.0% Male, 84.2% Male, 80.5% Male, 73.3% Male, 70.9% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Violence (n=3652) Suicide (n=1276) Transport (n=3237) Other Unintentional (n=932) Undetermined (n=1950) Percentageofcases Apparent manner of death
    13. 13. 0% 10% 20% 30% 40% 50% 60% 70% Percentageofcases Age groups Violence Suicide Transport Unintentional Undetermined
    14. 14. 0 500 1000 1500 2000 2500 3000 3500 4000 Farm Lake/river/dam Industrial area Medical service area Railway Open land Informal settlements Residential Institute Private homes Roads Number of deaths Sceneofinjury Violence Suicide Transport Other unintentional Undetermined
    15. 15. 0 50 100 150 200 250 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Numberofdeaths Time of death Violence Suicide Transport Other Unintentional Undetermined
    16. 16. Zero 55.7% 0-4mg/100ml 4.4% 5-14mg/100ml 13.4% 15- 24mg/100ml 16.3% 25+mg/100ml 10.2%
    17. 17. 0 500 1000 1500 2000 Passenger MVA unspecified Driver Burns Poisoning Hanging Blunt force Sharp force Pedestrian Firearm Number of deaths Externalcxauseofinjury Violence Suicide Transport Other unintentional Undetermined
    18. 18. Blood alcohol findings by apparent manner of death Apparent manner BAC's done n(%) BAC positive n(%) Mean BAC Std. Dev. Violence (3671) 953 (26.0) 463 (48.6) 0.16 0.09 Suicide (1278) 394 (30.8) 134 (34.1) 0.16 0.11 Transport (3248) 833 (25.7) 407 (48.9) 0.19 0.1 Other unintentional injury (937) 95 (10.1) 29 (30.5) 0.16 0.08 Undetermined (2195) 244 (11.1) 84 (34.4) 0.15 0.11 Total 2519 1117 0.16 0.1
    19. 19. Blood alcohol findings by transport user Transport user BAC's done n(%) BAC positive n(%) Mean BAC Std. Dev. Driver (542) 178 (32.8) 103 (57.9) 0.17 0.09 Passenger (522) 148 (28.4) 64 (43.2) 0.17 0.09 Pedestrian (1333) 290 (21.8) 153 (52.8) 0.23 0.11 Railway case (162) 38 (23.5) 10 (26.3) 0.12 0.08 Cyclist (151) 46 (30.5) 15 (32.6) 0.15 0.07 Unspecified (533) 132 (24.8) 62 (47.0) 0.16 0.09 Aviation (5) 1(20.0%) 0 0 0 Total 833 407 0.2 0.11
    20. 20. Year 2008 2009 Population# 7627922 7659017 Total deaths Rate/ 100 000 pop. Total deaths Rate/ 100000 pop. Violence 4223 51.7 3671 45.1 - firearm 1700 20.6 1374 16.4 - sharp force 1239 15.1 1074 13.1 - blunt force 1068 13.3 971 12.4 Suicide 1350 17.4 1278 16.5 - firearm 240 3.3 219 3.0 - hanging 738 9.2 676 8.5 - poisoning 233 3.0 249 3.1 Transport 3578 46.3 3248 41.6 - road traffic 3405 44.2 3081 39.5 - pedestrian 1441 18.9 1333 17.2 - driver 592 7.5 542 6.8 - passenger 649 8.5 522 6.6 - railway 147 1.9 162 2.1 Unintentional 1222 16.2 937 12.6 - burns 338 4.2 336 4.4 - drowning 207 2.6 134 1.7 - falls 112 1.7 94 1.5 ALL INJURIES 11565 147.1 11329 144.4
    21. 21. Mpumalanga South Africa Violence 33.2 64.8 - firearm 9.6 - sharp object 10.7 Suicide 17.1 14 - firearm 2.1 - hanging 11.6 ALL INJURIES 147.9 157.8
    22. 22. Mpumalanga South Africa Transport 68.4 - road traffic 68.1 39.7 driver 19.4 pedestrian 20.9 passenger 21.3 Other Unintentional 12.3 - burns 2.6 - drowning 3.0 ALL INJURIES 147.9 157.8
    23. 23.  A permanent, nationwide system that registers all non- natural deaths in South Africa  Automated NIMSS  Innovative  Funded by UNISA  Mpumalanga & Gauteng  Project concludes in 2011
    24. 24. Thank You Website: MRC-UNISA Crime, Violence and Injury Lead Programme/Safety and Peace Promotion Research Unit (SAPPRU) http://www.mrc.ac.za/crime/nimms.htm
    25. 25.  Staff and pathologists at participating MLLs and Forensic Medicine departments.  National and Provincial Departments of Health  State Forensic Pathology Services  Members of the NIMSS team

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