Firearm and nonfirearm homicide in 5 South African cities: a retrospective population-based study.

OBJECTIVE: We assessed the effectiveness of South Africa's Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005. METHODS: We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size. RESULTS: There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval [CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA. CONCLUSIONS: Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period.

Estimating the South African trauma caseload.

A survey of medical superintendents revealed that an estimated 1.5 million trauma cases presented to South Africa's 356 secondary and tertiary level hospitals in 1999. Injury rates for traffic, violence and other injuries showed considerable inter-provincial variation, with violence accounting for more than half of the trauma caseload. This type of survey is a simple low cost alternative for monitoring injury patterns and supplementing burden of disease and injury costing studies.