Introduction Violence and injury observatories (VIOs) are primarily a tool to aid safety and security stakeholders within both governments and non-governmental organisations to develop interventions focused on violence prevention and related to citizen safety issues. VIOs are centres that focus on collating and integrating violence-related injury data sources to monitor, evaluate, and study the progression of violence and crime in a targeted region. In preparation for implementing a pilot VIO in Cape Town, we sought to determine the optimal indicators, datasets and research priorities for inclusion. Methods The study employed a two-round Delphi study conducted via email. The Delphi panel constituted 21 participants. This included, but was not limited, to senior members of staff in the Provincial Health Services in Emergency Medicine and Disaster Medicine, representatives from relevant data stakeholders and non-government actors working in violence reduction. Results Fourteen violence-related indicators and 12 violence-related datasets reached consensus. Additionally, research priorities were identified within 16 research themes across five different types of violence: elder abuse, youth violence, intimate partner violence, sexual violence, and armed violence. Finally, four data-sharing questions raised by panellists after round one were answered by the Delphi panel following the second round. Discussion This study provides a research priority framework for violence and injury prevention work within South Africa. These expert-identified violence and injury indicators and datasets are context-appropriate and may serve to guide the development of additional VIOs within the region.
IntroductionThe true burden of group A streptococcal (GAS) disease in Africa is not known. GAS is a significant cause of mortality and morbidity on the global scale and in developing countries. According to Carapetis et al, the prevalence of severe GAS disease is at least 18.1 million cases with an incidence of at least 1.78 million cases per year.Methods and analysesWe aim to provide a systematic review of studies measuring the prevalence of GAS infection among people in North and Sub-Saharan African countries. A comprehensive literature search of a number of databases will be undertaken, using an African search filter, to identify GAS prevalence studies that have been published. Full copies of articles will be identified by a defined search strategy and will be considered for inclusion against predefined criteria. Statistical analysis will include two steps: (1) identification of data sources and documenting of estimates, and (2) the application of the random-effects and fixed-effects meta-analysis model to aggregate prevalence estimates, and to account for between study variability in calculating the overall pooled estimates and 95% CI for GAS prevalence. Heterogeneity will be evaluated using the I2 statistic to determine the extent of variation in effect estimates that is due to heterogeneity rather than chance. This systematic review protocol was prepared according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols (PRISMA-P) 2015 Statement. This review will provide updated evidence of a review published in 2009. Our data will have implications for the development of a GAS vaccine.Ethics and disseminationEthics approval is not required for this study given that this is a protocol for a systematic review of published studies. The results of this study will be disseminated through a peer-reviewed publication and conference presentation.Systematic review registration numberPROSPERO CRD4201401290 0. (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014012900).
Violence has been recognised officially as a global health issue, with the World Health Organization (WHO) reporting that 1.6 million people die annually from violence. South Africa's injury burden is very high, particularly for homicide, which is six times the global average. The idea of an 'observatory' has expanded recently, from its origins in astronomy to that of specialised informational repositories and knowledge-building centres, housing cross-referenced databases with advanced analytic and research capacities. This review essay provides information regarding the conceptual framework, historical background and various components of the violence observatory model, as well as evidence of effect. The intention is to provide information toCape were greater than the national average for both males and females. In Cape Town, the province's largest city and home to almost twothirds of the provincial population, the highest homicide counts for the period 2015 to 2016 were recorded in the relatively impoverished sub-districts of Nyanga (279 homicides) and Khayelitsha (161 homicides).14 While the criminal justice system remains the primary tool for responding to violence and injury in South Africa, evidence-based interventions for prevention are becoming increasingly influential in the field of public health, assuming a more central role in policymaking. 15 The public health approach to violence and injury prevention consists of three elements: assessing existing conditions; developing interventions; and evaluating programme effectiveness. 16Key to this approach is a surveillance system capable of providing essential information for the assessment phase in order to develop appropriate interventions and programme evaluation methods. 17Injury surveillance is widely recognised as a critical prerequisite for effective injury prevention.Ongoing surveillance can monitor the incidence of injury, identify risk factors and contribute to the planning and evaluation of injury prevention programmes. 18 Furthermore, injury surveillance can comprise a variety of data sources, from mortality and hospital discharge data to emergency department registry data, surveys and police, fire and ambulance records.This review suggests that violence and injury observatories are key to developing interventions that reduce the burden of injury in high-risk communities. We will use the term 'observatory' to denote a surveillance system that collects data from multiple sources, for example crime, clinical and forensic data, whereas injury surveillance systems almost exclusively focus on the use of injury data alone.In this article we will substantiate the following claims:• The observatories model is an internationally accepted tool that can provide a focused understanding of a particular issue or sub theme of violence.• The integration of violence and injury data may allow a comprehensive view of the existing burden of violence and injury within a community.• Observatories allow the opportunity to monitor current and prospective violence and i...
The establishment of violence and injury observatories elsewhere has been found to reduce the burden within a relatively short period. Currently no integrated system exists in South Africa to provide collated data on violence, to allow for targeted interventions and routine monitoring and evaluation. This research seeks to identify if bringing multiple data sources, including but not limited to data from the South African Police Service (SAPS), Forensic Pathology Services (FPS), Emergency Medical Services (EMS) and local hospital clinical databases, together are (1) feasible; (2) able to generate data for action, that is valid, reliable and robust and (3) able to lead to interventions.The violence, injury and trauma observatory (VITO) is a planned collaborative, multicentre study of clinical, police and forensic data for violence and injury in the City of Cape Town, where a local context exists of access to multiple source of health and non-health data. The VITO will initially be piloted in Khayelitsha, a periurban community characterised by increased rates of violence, where fatal and non-fatal injury data will be sourced from within the community for the period 2012–2015 and subjected to descriptive statistics and time-trend analyses. Analysed data will be visualised using story maps, data clocks, web maps and other geographical information systems-related products.This study has been approved by the University of Cape Town’s Human Research Ethics Committee (HREC 861/2016). We intend to disseminate our findings among stakeholders within the local government safety cluster, non-governmental organisations working within the violence prevention sector and the afflicted communities through the SAPS and violence prevention through urban upgrading community forums. Findings from this work will serve to identify important issues and trends, influence public policy and develop evidence-based interventions.
ObjectiveThe aim of this study was to summarise the results from existing studies reporting on the effectiveness of the introduction of violence and injury observatories (VIOs).DesignThis is a systematic review and meta-analysis study.Data sourcesWe searched multiple electronic databases including but not limited to PubMed, PsycINFO, SCOPUS, Cochrane Collaboration, Campbell Collaboration and Web of Knowledge.Eligibility criteriaWe included non-randomised controlled trials, quasi-experimental designs, prospective and retrospective cohort studies, controlled before-and-after studies and cross-sectional studies. We sought to include studies performed in any country and published in any language. The primary outcome was homicide, while the secondary outcome was assault.Data extraction and synthesisWe searched a number of databases, supplemented by searches in grey literature including technical reports. Searches comprised studies from January 1990 to October 2018.ResultsOf 3105 potentially relevant unique citations from all literature searches, 3 empirical studies and 4 technical reports met our inclusion criteria. Studies were conducted in the UK (n=3), Colombia (n=2), Brazil (n=1) and Uruguay (n=1). Subgroup analyses according to the two types of models implemented, the VIO and the injury surveillance system (ISS), provided evidence for an association between implementing the VIO model and a reduction in homicide count in high-violence settings (incidence rate ratio (IRR)=0.06; 95% CI 0.02 to 0.19; four studies), while the introduction of ISS showed significant results in reducing assault (IRR=0.80; 95% CI 0.71 to 0.91; three studies).ConclusionThis systematic review provides the best evidence available for the effectiveness of the introduction of VIOs and ISSs in reducing violence outcomes in adults in high-violence settings. The implementation of VIOs should be considered in high-violence communities where reduction in homicide rates is desired.PROSPERO registration numberCRD42014009818.
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