Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa.
Trop Med Int Health. 2011 Apr;16(4):439-46. doi: 10.1111/j.1365-3156.2011.02730.x. Epub 2011 Feb 1.
To 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.
The 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.
We 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)].
Reducing 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.
估计南非夸祖鲁-纳塔尔省农村人口的伤害死亡率，并确定与成人伤害相关死亡相关的社会人口学风险因素。
本研究使用人口监测系统收集的基于人群的死亡率数据，该系统对 11000 户家庭的所有居民和非居民成员进行了监测。将 2000 年 1 月 1 日至 2007 年 12 月 31 日期间的个人死亡和观察人年（pyo）进行汇总。死因通过口头尸检确定，使用 ICD-10 进行编码，并使用全球疾病负担类别进一步分类。使用回归分析检查与伤害相关的社会人口学风险因素。
我们分析了 133483 名个体的数据，这些个体的观察人年（pyo）为 717584.6 年，死亡人数为 11467 人。死亡人数中，有 8.9%是因伤害相关原因导致的；11%发生在 15 岁以下的儿童中。凶杀、道路交通伤害和自杀是主要原因。估计的粗伤害死亡率为 142.4（134.0，151.4）/100000 pyo；居民中的死亡率为 116.9（108.1，126.5）/100000 pyo，非居民中的死亡率为 216.8（196.5，239.2）/100000 pyo。在多变量分析中，居民和非居民之间的差异仍然存在，但在女性中不再具有统计学意义。在男性和女性中，全职工作与死亡率降低显著相关[调整后的比率比 0.6（0.4，0.9）；0.4（0.2，0.9）]；在男性中，更高的资产拥有量与死亡率增加独立相关[调整后的比率比 1.5（1.1，1.9）]。
要降低南非与伤害相关的高死亡率，需要采取跨部门的初级预防措施，以解决暴力和意外死亡的根本原因：社会不平等、贫困和酗酒。
