Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Population Health Metrics
Published in: Population Health Metrics 1/2015

Open Access 01-12-2015 | Research

High rates of homicide in a rural South African population (2000–2008): findings from a population-based cohort study

Authors: George Otieno, Edmore Marinda, Till Bärnighausen, Frank Tanser

Published in: Population Health Metrics | Issue 1/2015

Login to get access

Abstract

Background

South Africa has continued to receive increasing attention due to unprecedented high levels of violence. Homicide-related violence accounts for a significant proportion of unnatural deaths and contributes significantly to loss of years of expected life. We investigated levels and factors associated with homicide-related deaths and identify communities with excessively high homicide risk in a typical rural South African population.

Method

Data drawn from verbal autopsies conducted on all deaths recorded during annual demographic and health surveillance in KwaZulu Natal, South Africa were used to derive the cumulative probability of death from homicide over a nine-year period (2000–2008). Weibull regression methods were used to investigate factors associated with homicide deaths. A Kulldorff spatial scan statistic was used to identify spatial clusters of homicide-related deaths.

Results

With 536 homicide-related deaths, and a median seven years of follow-up, the study found an overall homicide incidence rate of 66 deaths per 100, 000 person-years of observation (PYOs) (95 % CI 60-72) for the period under study. Death related to the use of firearms was the leading reported method of homicide (65 %) and most deaths occurred over weekends (43 %). Homicides are the second-most common cause of death in men aged 25–34 after HIV-related deaths (including TB) in this community, at 210 deaths per 100,000 PYOs, and was highest among 55–64 year old women, at 78 deaths per 100,000 PYOs. Residency status, age, socioeconomic status, and highest education level attained independently predicted the risk of homicide death. The spatial distribution of homicide deaths was not homogenous and the study identified two clear geographical clusters with significantly elevated homicide risk.

Conclusion

The high rates of homicide observed in this typical rural South African population – particularly among men – underscore the need for urgent interventions to reduce this tragic and theoretically preventable loss of life in this population and similar South African settings.
Literature
1.
Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet. 2002;360(9339):1083–8.CrossRefPubMed
2.
3.
4.
Seedat M, Van Niekerk A, Jewkes R, Suffla S, Ratele K. Violence and injuries in South Africa: prioritising an agenda for prevention. Lancet. 2009;374(9694):1011–22.CrossRefPubMed
5.
Bronwyn H. Spaces of violence, places of fear: Urban conflict in post-apartheid South Africa. In: Paper presented on the Conflicts and Urban Violence panel, Foro Social Mundial Tematico, Cartagena, Colombia, 16-20 June 2003, vol. 16. 2003.
6.
Matzopoulos R, Myers JE, Bowman B, Mathews S. Interpersonal violence prevention: prioritising interventions. S Afr Med J. 2008;98(9):682, 684, 686. passim.
7.
UNODC. Global Study on Homicide. In: (United Nations publication, Sales No 14IV1). 2013.
8.
Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. The health and health sysytem of South Africa: historical roots of current public health challenges. Lancet. 2009. doi:10.​1016/​S0140-6736(09)60951-X. published online August 25.
9.
Setel PW, Macfarlane SB, Szreter S, Mikkelsen L, Jha P, Stout S, et al. A scandal of invisibility: making everyone count by counting everyone. Lancet. 2007;370(9598):1569–77.CrossRefPubMed
10.
Joubert J, Rao C, Bradshaw D, Vos T, Lopez AD. Evaluating the quality of national mortality statistics from civil registration in South Africa, 1997-2007. PLoS One. 2013;8(5):e64592.CrossRefPubMedPubMedCentral
11.
Chalapati R, Bradshaw D, Colin DM. Improving death registration and statistics in developing countries: Lessons from sub-Saharan Africa. S Afr J Demog. 2004;9:81–91.
12.
Bhalla K, Harrison JE, Shahraz S, Fingerhut LA. Availability and quality of cause-of-death data for estimating the global burden of injuries. Bull World Health Organ. 2010;88(11):831–838C.CrossRefPubMedPubMedCentral
13.
14.
Tanser F, Barnighausen T, Grapsa E, Zaidi J, Newell ML. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;339(6122):966–71.CrossRefPubMedPubMedCentral
15.
Bor J, Herbst AJ, Newell ML, Barnighausen T. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science. 2013;339(6122):961–5.CrossRefPubMed
16.
Hontelez JA, de Vlas SJ, Baltussen R, Newell ML, Bakker R, Tanser F, et al. The impact of antiretroviral treatment on the age composition of the HIV epidemic in sub-Saharan Africa. Aids. 2012;26 Suppl 1:S19–30.CrossRefPubMed
17.
Lurie MN, Williams BG, Zuma K, Mkaya-Mwamburi D, Garnett G, Sturm AW, et al. The impact of migration on HIV-1 transmission in South Africa: a study of migrant and nonmigrant men and their partners. Sex Transm Dis. 2003;30(2):149–56.CrossRefPubMed
18.
Kahn K, Tollman SM, Collinson MA, Clark SJ, Twine R, Clark BD, et al. Research into health, population and social transitions in rural South Africa: data and methods of the Agincourt Health and Demographic Surveillance System. Scand J Public Health Suppl. 2007;69:8–20.CrossRefPubMedPubMedCentral
19.
20.
Misganaw A, Mariam DH, Araya T, Aneneh A. Validity of verbal autopsy method to determine causes of death among adults in the urban setting of Ethiopia. BMC Med Res Methodol. 2012;12:130.CrossRefPubMedPubMedCentral
21.
Setel PW, Whiting DR, Hemed Y, Chandramohan D, Wolfson LJ, Alberti KG, et al. Validity of verbal autopsy procedures for determining cause of death in Tanzania. Trop Med Int Health. 2006;11(5):681–96.CrossRefPubMed
22.
Case A, Hosegood V, Lund F. The reach and impact of Child Support Grants: evidence from KwaZulu-Natal. Development Southern Africa Development South Africa. 2005;22(4):467–82.CrossRef
23.
Kulldorff M, Heffernan R, Hartman J, Assuncao R, Mostashari F. A space-time permutation scan statistic for disease outbreak detection. PLoS Med. 2005;2(3):e59.CrossRefPubMedPubMedCentral
24.
25.
Tanser F, Barnighausen T, Cooke GS, Newell ML. Localized spatial clustering of HIV infections in a widely disseminated rural South African epidemic. Int J Epidemiol. 2009;38(4):1008–16.CrossRefPubMedPubMedCentral
26.
Tanser F, Barnighausen T, Newel M. Identification of localized clusters of high HIV incidence in a widely disseminated rural South Africa epidemic: a case for targeted intervention strategies. Conference on Retroviruses and opportunistic infection in; March. CROI 2011.
27.
28.
29.
Outwater AH, Campbell JC, Mgaya E, Abraham AG, Kinabo L, Kazaura M, et al. Homicide death in Dar es Salaam, Tanzania 2005. Int J Inj Contr Saf Promot. 2008;15(4):243–52.CrossRefPubMed
30.
31.
Mathews S, Abrahams N, Jewkes R, Martin LJ, Lombard C. The epidemiology of child homicides in South Africa. Bull World Health Organ. 2009;91(8):562–8.CrossRef
32.
Karch DL, Dahlberg LL, Patel N, Davis TW, Logan JE, Hill HA, et al. Surveillance for Violent Deaths -- National Violent Death Reporting System, 16 States, 2006. MMWR: Morbidity & Mortality Weekly Report. 2009;58(SS-1):1–43.
33.
Kann L, Kinchen SA, Williams BI, Ross JG, Lowry R, Hill CV, et al. Youth risk behavior surveillance-United States, 1997. Morbidity and Mortality Weekly Report. 1998;47(SS-3):iv-iv.
34.
Ehrlich RI, White N, Norman R, Laubscher R, Steyn K, Lombard C, et al. Predictors of chronic bronchitis in South African adults. Int J Tuberc Lung Dis. 2004;8(3):369–76.PubMed
35.
Richard G, Matzopoulos RG, Thompson ML, Myers JE. Firearm and nonfirearm homicide in 5 South African cities: a retrospective population-based study. Am J Public Health. 2014;104(3):455–60.CrossRef
36.
Gawryszewski VP, Kahn T, de Mello Jorge MH. Linking of information from health and security databases on homicides. Rev Saude Publica. 2005;39(4):627–33.CrossRefPubMed
37.
38.
Andreuccetti G, de Carvalho HB, de Carvalho PJ, de Carvalho DG, Kahn T, Munoz DR, et al. Alcohol consumption in homicide victims in the city of Sao Paulo. Addiction. 2009;104(12):1998–2006.CrossRefPubMed
39.
Meel BL. Firearm fatalities in the Transkei region of South Africa, 1993-2004. S Afr Med J. 2005;95(12):963–7.PubMed
40.
Matzopoulos R, Seedat M, Cassim M. A profile of fatal injuries in South Africa: Fourth annual report of the National Injury Mortality Surveillance system (NIMSS). Cape Town: South African Medical Research Council/University of South Africa Crime, Violence and Injury Lead Programme; 2002.
41.
Bradshaw D, Nannan N, Groenewald P, Joubert J, Laubscher R, Nojilana B, et al. Provincial mortality in South Africa, 2000--priority-setting for now and a benchmark for the future. S Afr Med J. 2005;95(7):496–503.PubMed
42.
Parry CD, Pluddemann A, Steyn K, Bradshaw D, Norman R, Laubscher R. Alcohol use in South Africa: findings from the first Demographic and Health Survey (1998). J Stud Alcohol. 2005;66(1):91–7.CrossRefPubMed
43.
Cubbin C, Smith GS. Socioeconomic Inequalities In Injury: Critical Issues in Design and Analysis April 2002. Annual Review of Public Health. 2002;23:349–75.CrossRefPubMed
44.
Schneider M, Bradshaw D, Steyn K, Norman R, Laubscher R. Poverty and non-communicable diseases in South Africa. Scand J Public Health. 2009;37(2):176–86.CrossRefPubMed
45.
Doolan K, Ehrlich R, Myer L. Experience of violence and socioeconomic position in South Africa: a national study. PLoSOne. 2007;2(12):e1290.CrossRef
Metadata
Title
High rates of homicide in a rural South African population (2000–2008): findings from a population-based cohort study
Authors
George Otieno
Edmore Marinda
Till Bärnighausen
Frank Tanser
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Population Health Metrics / Issue 1/2015
Electronic ISSN: 1478-7954
DOI
https://doi.org/10.1186/s12963-015-0054-0

Other articles of this Issue 1/2015

Population Health Metrics 1/2015 Go to the issue

Research

Modeling contextual effects using individual-level data and without aggregation: an illustration of multilevel factor analysis (MLFA) with collective efficacy

Research

Mapping malaria risk and vulnerability in the United Republic of Tanzania: a spatial explicit model

Research

Smoking, smoking cessation, and 7-year mortality in a cohort of Thai adults

Research

Effects of a health information system data quality intervention on concordance in Mozambique: time-series analyses from 2009–2012

Review

The Population Health Model (POHEM): an overview of rationale, methods and applications

Research

Assessing disability weights based on the responses of 30,660 people from four European countries