Richard Matzopoulos1, Pamela Groenewald, Naeemah Abrahams, Debbie Bradshaw. 1. South African Medical Research Council Burden of Disease Research Unit, Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa. richard.matzopoulos@mrc.ac.za.
Abstract
BACKGROUND: The low number of firearm assaults and overall assault-related deaths in Statistics South Africa's death notification reports is incongruous with other recently released data, including police crime statistics. METHODS: We conducted a review of all gunshot injuries recorded in death notifications from 1997 to 2013, including all cases in which the underlying cause of death was ascribed to cause-specific codes in the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) that referred to a gunshot injury. RESULTS: We identified 105 694 gunshot-related injury deaths over the 17-year period, an average of 6 217 per annum. The total annual number of gunshot injuries increased from 1997 to 2000, at which point firearm-related deaths peaked at 9 540 recorded cases. Thereafter there was a steadily decreasing trend (interrupted only in 2006 and 2008) until 2011, when 3 793 deaths were attributed to gunshot-related injuries as the underlying cause - a decrease of >60% from the peak in 2000. CONCLUSION: The cause-specific profile for gunshot injury deaths in this study indicated extensive misclassification, which explained the near-absence of these injuries among assault cases. However, the trend in gunshot-related injury deaths irrespective of intent provides further support for the hypothesis that stricter gun control, coinciding with the implementation of the Firearms Control Act of 2000, accounts for this decrease.
BACKGROUND: The low number of firearm assaults and overall assault-related deaths in Statistics South Africa's death notification reports is incongruous with other recently released data, including police crime statistics. METHODS: We conducted a review of all gunshot injuries recorded in death notifications from 1997 to 2013, including all cases in which the underlying cause of death was ascribed to cause-specific codes in the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) that referred to a gunshot injury. RESULTS: We identified 105 694 gunshot-related injury deaths over the 17-year period, an average of 6 217 per annum. The total annual number of gunshot injuries increased from 1997 to 2000, at which point firearm-related deaths peaked at 9 540 recorded cases. Thereafter there was a steadily decreasing trend (interrupted only in 2006 and 2008) until 2011, when 3 793 deaths were attributed to gunshot-related injuries as the underlying cause - a decrease of >60% from the peak in 2000. CONCLUSION: The cause-specific profile for gunshot injury deaths in this study indicated extensive misclassification, which explained the near-absence of these injuries among assault cases. However, the trend in gunshot-related injury deaths irrespective of intent provides further support for the hypothesis that stricter gun control, coinciding with the implementation of the Firearms Control Act of 2000, accounts for this decrease.
Authors: Mohsen Naghavi; Laurie B Marczak; Michael Kutz; Katya Anne Shackelford; Megha Arora; Molly Miller-Petrie; Miloud Taki Eddine Aichour; Nadia Akseer; Rajaa M Al-Raddadi; Khurshid Alam; Suliman A Alghnam; Carl Abelardo T Antonio; Olatunde Aremu; Amit Arora; Mohsen Asadi-Lari; Reza Assadi; Tesfay Mehari Atey; Leticia Avila-Burgos; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Shahrzad Bazargan-Hejazi; Masoud Behzadifar; Meysam Behzadifar; James R Bennett; Ashish Bhalla; Zulfiqar A Bhutta; Arebu Issa Bilal; Guilherme Borges; Rohan Borschmann; Alexandra Brazinova; Julio Cesar Campuzano Rincon; Félix Carvalho; Carlos A Castañeda-Orjuela; Lalit Dandona; Rakhi Dandona; Paul I Dargan; Diego De Leo; Samath Dhamminda Dharmaratne; Eric L Ding; Huyen Phuc Do; David Teye Doku; Kerrie E Doyle; Tim Robert Driscoll; Dumessa Edessa; Ziad El-Khatib; Aman Yesuf Endries; Alireza Esteghamati; Andre Faro; Farshad Farzadfar; Valery L Feigin; Florian Fischer; Kyle J Foreman; Richard Charles Franklin; Nancy Fullman; Neal D Futran; Tsegaye Tewelde Gebrehiwot; Reyna Alma Gutiérrez; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Gessessew Bugssa Hailu; Josep Maria Haro; Hamid Yimam Hassen; Caitlin Hawley; Delia Hendrie; Martha Híjar; Guoqing Hu; Olayinka Stephen Ilesanmi; Mihajlo Jakovljevic; Spencer L James; Sudha Jayaraman; Jost B Jonas; Amaha Kahsay; Amir Kasaeian; Peter Njenga Keiyoro; Yousef Khader; Ibrahim A Khalil; Young-Ho Khang; Jagdish Khubchandani; Aliasghar Ahmad Kiadaliri; Christian Kieling; Yun Jin Kim; Soewarta Kosen; Kristopher J Krohn; G Anil Kumar; Faris Hasan Lami; Van C Lansingh; Heidi Jane Larson; Shai Linn; Raimundas Lunevicius; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Reza Malekzadeh; Deborah Carvalho Malta; Amanda J Mason-Jones; Richard Matzopoulos; Peter T N Memiah; Walter Mendoza; Tuomo J Meretoja; Haftay Berhane Mezgebe; Ted R Miller; Shafiu Mohammed; Maziar Moradi-Lakeh; Rintaro Mori; Devina Nand; Cuong Tat Nguyen; Quyen Le Nguyen; Dina Nur Anggraini Ningrum; Felix Akpojene Ogbo; Andrew T Olagunju; George C Patton; Michael R Phillips; Suzanne Polinder; Farshad Pourmalek; Mostafa Qorbani; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Rajesh Kumar Rai; Chhabi Lal Ranabhat; David Laith Rawaf; Salman Rawaf; Ali Rowhani-Rahbar; Mahdi Safdarian; Saeid Safiri; Rajesh Sagar; Joseph S Salama; Juan Sanabria; Milena M Santric Milicevic; Rodrigo Sarmiento-Suárez; Benn Sartorius; Maheswar Satpathy; David C Schwebel; Soraya Seedat; Sadaf G Sepanlou; Masood Ali Shaikh; Nigussie Tadesse Sharew; Ivy Shiue; Jasvinder A Singh; Mekonnen Sisay; Vegard Skirbekk; Adauto Martins Soares Filho; Dan J Stein; Mark Andrew Stokes; Mu'awiyyah Babale Sufiyan; Mamta Swaroop; Bryan L Sykes; Rafael Tabarés-Seisdedos; Fentaw Tadese; Bach Xuan Tran; Tung Thanh Tran; Kingsley Nnanna Ukwaja; Tommi Juhani Vasankari; Vasily Vlassov; Andrea Werdecker; Pengpeng Ye; Paul Yip; Naohiro Yonemoto; Mustafa Z Younis; Zoubida Zaidi; Maysaa El Sayed Zaki; Simon I Hay; Stephen S Lim; Alan D Lopez; Ali H Mokdad; Theo Vos; Christopher J L Murray Journal: JAMA Date: 2018-08-28 Impact factor: 56.272