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Objective To investigate injury-related mortality in South Africa using a nationally representative sample and compare the results with previous estimates. Methods We conducted a retrospective descriptive study of medico-legal postmortem investigation data from mortuaries using a multistage random sample, stratified by urban and non-urban areas and mortuary size. We calculated age-specific and age- standardized mortality rates for external causes of death. Findings Postmortem reports revealed 52493 Injury-related deaths in 2009 (95% confidence interval, CI: 46930-58057). Almost half (25499) were Intentionally inflicted. Age-standardized mortality rates per 100000 population vyere as follows: all injuries: 109.0 (95% CI: 97.1-121.0); homicide 38.4 (95% CI: 33.8-43.0; suicide 13.4 (95% CI: 11.6-15.2) and road-traffic injury 36.1 (95% CI: 30.9-41.3). Using postmortem reports, we found more than three times as many deaths from homicide and road-traffic injury than had been recorded by vital registration for this period. The homicide rate was similar to the estimate for South Africa from a global analysis, but road-traffic and suicide rates were almost fourfold higher. Conclusion This is the first nationally representative sample of injury-related mortality in South Africa. It provides more accurate estimates and cause-specific profiles that are not available from other sources. Objectif Enqueter sur la mortalite par traumatisme en Afrique du Sud a partir d'un echantlllon natlonalement representatlf et comparer les resultats avec les estimations anterieures. Methodes Nous avons realise une etude descriptive retrospective des donnees de rapports medico-legaux obtenus aupres de morgues, en utilisant une technique d'echantillonnage aleatoire a plusieurs degres, stratifie en fonction des criteres suivants: zone urbaine, zone non urbaine et taille de la morgue. Nous avons calcule les taux de mortalite par age et les taux de mortalite standardlses selon l'age, pour les differentes causes externes de deces. Resultats Les dossiers d'autopsie font etat de 52.493 deces par traumatisme en 2009 (intervalle de confiance de 95 %, IC: 46.930-58.057). Quasiment la moitle (25.499 deces) correspond a des blessures infligees intentionnellement. Taux de mortalite standardise selon l'age pour 100.000 personnes: Tous types de blessures: 109,0 (1C 95 %: 97,1-121,0); Homicides 38,4 (IC 95%: 33,8-43); Suicides 13,4 (IC 95%: 11,6-15,2); Blessures llees a des accidents de transport 36,1 (IC 95%: 30,9-41,3). Les rapports d'autopsie indiquent un nombre de deces par homicide et accident de la route plus de trols fois superleur aux chiffres recenses dans les registres d'etat civil pour la meme periode. Le taux d'homicide a confirme les estimations prealablement faites pour l'Afrlque du Sud dans une analyse internationale. En revanche, les taux correspondan aux accidents de la route et aux suicides se sont averes pres de quatre fois plus eleves. Conclusion Il s'agit du tout premier echantlllon nationalement representatif pour la mortalite par traumatisme en Afrique du Sud. Cette etude offre des estimations plus precises et des profils detailles par causes, qui ne sont disponibles dans aucune autre source. Objetivo Investigar la mortalidad relacionada con los traumatismos en Sudafrica utilizando una muestra representativa a nivel nacional y comparar los resultados con estimaciones anteriores. Metodos Se llevo a cabo un estudio retrospectivo y descriptivo de datos medico-legales de Investigaciones post mortem utilizando una muestra aleatoria en varias etapas, estratificado por zonas urbanas y zonas no urbanas y el tamano de la morgue. Se calcularon las tasas de mortalidad especificas y normalizadas por edades de causas de muerte externas. Resultados Los informes post mortem revelaron 52.493 muertes relacionadas con traumatismos en 2009 (intervalo de confianza, IC, del 95%: 46.930-58.057). Casi la mitad (25.499) fueron infligidas intencionadamente. Las tasas de mortalidad normalizadas por edades por 100.000 habitantes fueron las siguientes: todos los traumatismos: 109,0 (IC del 95%: 97,1-121,0); homicidio 38,4 (IC del 95%: 33,8-43); suicidio 13,4 (IC del 95%: 11,6-15,2) y traumatismos relacionados con el transporte 36,1 (IC del 95%: 30,9-41,3). Utilizando informes post mortem, se observaron tres veces mas casos de muertes por homicidio y traumatismos por accidentes de trafico que la cantidad registrada en el registro civil para este periodo. La tasa de homicidio fue similar a la estimacion para Sudafrica desde una perspectiva global, pero las tasas de accidentes de trafico y suicidios fueron casi cuatro veces superiores. Conclusion Esta es la primera muestra representativa a nivel nacional de mortalidad relacionada con los traumatismos en Sudafrica. Proporciona estimaciones mas precisas y perfiles por causas especificas que no pueden obtenerse de otras fuentes., Introduction In South Africa in the year 2000, injury-related mortality accounted for 12% of deaths and 16% of years of life lost. (1) This was primarily due to high mortality [...]

Objectives: To identify health care provider-related determinants of diabetes and hypertension management in patients attending public sector community health centres (CHCs)., Methods: A random sample of 18 CHCs in the Cape Peninsula providing hypertension and diabetes care was selected. Twenty-five patients with diabetes and 35 with hypertension per clinic were selected and interviewed by trained fieldworkers, and their medical records were audited. Regression analyses identified predictors of controlled hypertension (< 140/90 mmHg) and diabetes (HbA1c < 7%). In-depth interviews with nurses and doctors explored their experiences in working at the CHCs. Height, weight and blood pressure (BP) were measured for all patients and random blood samples collected for lipids, glucose, HbA1c and creatinine., Results: Of the participants 923 had hypertension and 455 diabetes (289 had both conditions). Of the hypertensive patients 33% had a BP < 140/90 mmHg, while 42% of the patients with diabetes had non-fasting glucose levels below 11.1 mmol/l. Patients' knowledge about their conditions was poor. Prescriptions for drugs were not recorded in medical records of 22.6% of the patients with diabetes and 11.4% of those with hypertension., Conclusions: Primary care for patients with hypertension and diabetes at public sector CHCs is suboptimal. This study highlights the urgent need to improve health care for patients with these conditions in public sector clinics in the Cape Peninsula.