Assault-injured youth in the emergency centres of Khayelitsha, South Africa: A prospective study of recidivism and mortality.

Autor:	Leeper SC; University of Maryland Medical Center, Emergency Medicine, Cheverly, MD, USA., Patel MD; University of North Carolina at Chapel Hill School of Medicine, Department of Emergency Medicine, Chapel Hill, NC, USA., Lahri S; Khayelitsha Hospital, Khayelitsha, Cape Town, South Africa.; University of Stellenbosch, Division of Emergency Medicine, Tygerberg, Cape Town, South Africa., Beja-Glasser A; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Reddy P; Human Sciences Research Council Pretoria, HSRC Bldg, Arcadia, Pretoria, South Africa., Martin IBK; Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, WI, USA., van Hoving DJ; University of Stellenbosch, Division of Emergency Medicine, Tygerberg, Cape Town, South Africa., Myers JG; University of North Carolina at Chapel Hill School of Medicine, Department of Emergency Medicine, Chapel Hill, NC, USA.
Jazyk:	angličtina
Zdroj:	African journal of emergency medicine : Revue africaine de la medecine d'urgence [Afr J Emerg Med] 2021 Dec; Vol. 11 (4), pp. 379-384. Date of Electronic Publication: 2021 Sep 06.
DOI:	10.1016/j.afjem.2021.07.001
Abstrakt:	Introduction: Violence is a major cause of death worldwide among youth. The highest mortality rates from youth violence occur in low and middle-income countries (LMICs). We sought to identify risk factors for violent re-injury and emergency centre (EC) recidivism among assault-injured youth in South Africa. Methods: A prospective follow up study of assault injured youth and controls ages 14-24 presenting for emergency care was conducted in Khayelitsha, South Africa from 2016 to 2018. Sociodemographic and behavioral factors were assessed using a questionnaire administered during the index EC visit. The primary outcomes were return EC visit for violent injury or death within 15 months. We used multivariable logistic regression to compute adjusted odds ratios (OR) and 95% confidence intervals (CI) of associations between return EC visits and key demographic, social, and behavioral factors among assault-injured youth. Results: Our study sample included 320 assault-injured patients and 185 non-assault-injured controls. Of the assault-injured, 80% were male, and the mean age was 20.8 years. The assault-injured youth was more likely to have a return EC visit for violent injury (14%) compared to the control group (3%). The non-assault-injured group had a higher mortality rate (7% vs 3%). All deaths in the control group were due to end-stage HIV or TB-related complications. The strongest risk factors for return EC visit were prior criminal activity (OR = 2.3, 95% CI = 1.1-5.1), and current enrollment in school (OR = 2.1, 95% CI = 1.0-4.6). Although the assault-injured group reported high rates of binge drinking (73%) at the index visit, this was not found to be a risk factor for violence-related EC recidivism. Discussion: Our findings suggest that assault-injured youth in an LMIC setting are at high risk of EC recidivism and several sociodemographic and behavioral factors are associated with increased risk. These findings can inform targeted intervention programs. Competing Interests: The authors declare no conflicts of interest. (© 2021 The Authors.)
Databáze:	MEDLINE
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