Community assault and non-community assault among adults in Khayelitsha: A case count and comparison of injury severity

Forgus, Sheron (2015-07-23)

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Background: Community Assault (CA) or vigilantism is rife in the township of Khayelitsha. Anecdotal evidence suggests that victims of CA are worse off than other assault cases. However, scientific data on the rate and severity of CA cases is lacking for South Africa. Aims and Objectives: To contribute to CA prevention and management strategies, by estimating the rate of CA among adults in Khayelitsha and comparing the injury severity and survival probability between cases of CA and other assault (non-CA) cases. Methods: We studied 4 health centres in Khayelitsha during July - December 2012. A consecutive case-series was conducted to capture all CA cases during this period and a retrospective folder review was performed on all cases of CA as well as on a control group of non-CA cases to compare injury severity and estimate survival probability. Results: One hundred and forty-eight adult cases of CA occurred (case rate 1.1/1000 person-years) over the study period. The Injury Severity Scores (ISS) in the CA group were significantly higher than in the non-CA group (P<0.001), with a median (Inter Quartile Range) ISS of 3 in CA cases (2-6) and 1 in non-CA cases (1-2). Comparison between the two groups showed that a GCS<15 (20.1% versus 5.4%), referral to the tertiary hospital (33.8% versus 22.6%), and crush syndrome (25.7% versus 0%) were all more common in CA cases. Survival probabilities were similar in both groups: 99.2% in the CA group versus 99.3% in the non-CA group. Conclusion: The rate of CA among adults in Khayelitsha is high, and the severity of injuries sustained by CA victims is substantially higher than in other assault cases.

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