Further evidence of misclassification of the injury deaths in South Africa: When will the barriers to accurate injury death statistics be removed?

• DOI: 10.7196/samj.2023.v113i9.836
• Publication Date: 2023-09-04T15:08:53Z
• Authors: P Groenewald; N Kallis; C Holmgren; T Glass; A Anthony; P Maud; Y Akhalwaya; E Afonso; I Niewoudt; L J Martin; C De Vaal; M Cheyip; D Morof; M Prinsloo; R Matzopoulos; D Bradshaw
• Keywords: Death certificate; Homicide; Under-reporting

Background. Contrary to the World Health Organization’s internationally recommended medical certificate of cause death, South African (SA) death notification form (DNF) does not allow for reporting manner permit accurate coding external causes injury deaths. Objectives. To describe cause-of-death profile from forensic pathology records collected National Cause-of-Death Validation (NCoDV) Project and compare it with profiles other sources mortality data. In particular, recording firearm use in homicides is compared between sources. Methods. The NCoDV was a cross-sectional study deaths that occurred during fixed period 2017 2018, nationally representative sample 27 health subdistricts SA. Trained fieldworkers scanned all investigated at mortuaries serving sampled period. Forensic practitioners reviewed completed each decedent. Causes were coded International Statistical Classification Diseases, 10th revision (ICD-10), using Iris automated software. Cause-specific fractions Injury Mortality Survey (IMS 2017) Statistics Africa (Stats SA datasets. firearm-related three Results. A total 5 315 available analysis. Males accounted 77.6% cases, most decedents aged 25 44 years. Homicide leading (34.7%), followed by transport injuries (32.6%) suicide (14.7%). This similar IMS but differed markedly official statistics, which showed lower proportions these (15.0%, 11.6% 0.7%, respectively), much higher proportion unintentional causes. Investigation revealed 2017/18 (88.5%) (93.1%), while Stats data, 98.7% classified as accidental. Approximately 7% suicides 2017, only 0.3% 2017. Conclusion. data substantially findings Accurate would ensure public interventions are designed reduce high burden. Inclusion on DNF, internationally, critically important enable more accurate, reliable valid profile.