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The malignant epidemic--changing patterns of trauma.
Douglas M G Bowley1, Ali Khavandi, Kenneth D Boffard
1Johannesburg Hospital Trauma Unit, Department of Surgery, University of the Witwatersrand.
South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|November 16, 2002
Summary
Trauma cases in South Africa have significantly increased, primarily due to interpersonal violence. Gunshot wounds are a rising cause of unnatural deaths, necessitating urgent interventions to address this trauma epidemic.
Area of Science:
- Public Health
- Epidemiology
- Trauma Surgery
Background:
- The global burden of trauma is escalating, with South Africa experiencing a disproportionate impact on its young population.
- Trauma significantly strains healthcare infrastructure, necessitating an understanding of evolving injury patterns.
Purpose of the Study:
- To analyze trends in trauma patient demographics and injury mechanisms over a 17-year period (1985-2001) at the Johannesburg Hospital Trauma Unit (JHTU).
- To examine changes in the patterns of unnatural deaths at the Johannesburg Medicolegal Laboratory (JMLL) during a period of significant socio-political transformation.
Main Methods:
- Retrospective review of priority-one trauma patients at JHTU (1985-2001).
- Analysis of JHTU trauma database for demographics, wound mechanism, and injury severity.
- Examination of JMLL database (since 1996) for manner and place of death.
Main Results:
- A substantial increase in trauma patient numbers at JHTU over 17 years.
- Shift in patient demographics and a predominance of interpersonal violence as the cause of injury.
- Decline in overall unnatural deaths at JMLL, but a rise in the proportion attributed to gunshot wounds.
Conclusions:
- Socio-political changes in South Africa correlate with altered injury profiles.
- Factors contributing to increased trauma include desegregation, reduced hospital services, urbanization, migration, and substance abuse.
- Urgent implementation of multi-level interventions is crucial to mitigate South Africa's escalating trauma epidemic.