title: Intentional injury and violence in Cape Town, South Africa: an epidemiological analysis of trauma admissions data.
abstract: BACKGROUND
  Injury is a truly global health issue that has enormous societal and economic consequences in all countries. Interpersonal violence is now widely recognized as important global public health issues that can be addressed through evidence-based interventions. In South Africa, as in many low- and middle-income countries (LMIC), a lack of ongoing, systematic injury surveillance has limited the ability to characterize the burden of violence-related injury and to develop prevention programmes.
  
  
  OBJECTIVE
  To describe the profile of trauma presenting to the trauma centre of Groote Schuur Hospital in Cape Town, South Africa - relating to interpersonal violence, using data collected from a newly implemented surveillance system. Particular emphasis was placed on temporal aspects of injury epidemiology, as well as age and sex differentiation.
  
  
  METHODS
  Data were collected prospectively using a standardized trauma admissions form for all patients presenting to the trauma centre. An epidemiological analysis was conducted on 16 months of data collected from June 2010 to October 2011.
  
  
  RESULTS
  A total of 8445 patients were included in the analysis, in which the majority were violence-related. Specifically, 35% of records included violent trauma and, of those, 75% of victims were male. There was a clear temporal pattern: a greater proportion of intentional injuries occur during the night, while unintentional injury peaks late in the afternoon. In total, two-third of all intentional trauma is inflicted on the weekends, as is 60% of unintentional trauma. Where alcohol was recorded in the record, 72% of cases involved intentional injury. Sex was again a key factor as over 80% of all records involving alcohol or substance abuse were associated with males. The findings highlighted the association between violence, young males, substance use, and weekends.
  
  
  CONCLUSIONS
  This study provides the basis for evidence-based interventions to reduce the burden of intentional injury. Furthermore, it demonstrates the value of locally appropriate, ongoing, systematic public health surveillance in LMIC.
authors.affiliation: Department of Geography, Simon Fraser University, Burnaby, BC, Canada; nadine@sfu.ca.
authors.forename: Nadine
authors.initials: N
authors.lastname: Schuurman
authors.affiliation: Department of Geography, University of Exeter, Exeter, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cinnamon
authors.affiliation: Department of Geography, Simon Fraser University, Burnaby, BC, Canada.
authors.forename: Blake Byron
authors.initials: BB
authors.lastname: Walker
authors.affiliation: Department of Surgery, University of Virginia, Charlottesville, VA, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Fawcett
authors.affiliation: Trauma Unit, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Andrew
authors.initials: A
authors.lastname: Nicol
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Syed Morad
authors.initials: SM
authors.lastname: Hameed
authors.affiliation: School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Richard
authors.initials: R
authors.lastname: Matzopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062486:Public Health Surveillance; D012737:Sex Factors; D012931:Social Environment; D013019:South Africa / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: Cape Town; South Africa; injury; intentional; surveillance; trauma; violence