@article{ref1,
title="Interpersonal violence in peacetime Malawi",
journal="Trauma surgery and acute care open",
year="2018",
author="Maine, Rebecca G. and Williams, Brittney and Kincaid, Jennifer A. and Mulima, Gift and Varela, Carlos and Gallaher, Jared R. and Reid, Trista D. and Charles, Anthony G.",
volume="3",
number="1",
pages="e000252-e000252",
abstract="BACKGROUND: The contribution of interpersonal violence (IPV) to trauma burden varies greatly by region. The high rates of IPV in sub-Saharan Africa are thought to relate in part to the high rates of collective violence. Malawi, a country with no history of internal collective violence, provides an excellent setting to evaluate whether collective violence drives the high rates of IPV in this region. <br><br>METHODS: This is a retrospective review of a prospective trauma registry from 2009 through 2016 at Kamuzu Central Hospital in Lilongwe, Malawi. Adult (>16 years) victims of IPV were compared with non-intentional trauma victims. Log binomial regression determined factors associated with increased risk of mortality for victims of IPV. <br><br>RESULTS: Of 72 488 trauma patients, 25 008 (34.5%) suffered IPV. Victims of IPV were more often male (80.2% vs. 74.8%; p<0.001), younger (median age: 28 years (IQR: 23-34) vs. 30 years (IQR: 24-39); p<0.001), and were more often admitted at night (47.4% vs. 31.9%; p<0.001). Of the IPV victims, 16.5% admitted alcohol use, compared with only 4.4% in other trauma victims (p<0.001). In regression modeling, compared with extremity injuries, head injuries (3.14, 2.24-4.39; p<0.001) and torso injuries (4.32, 2.98-6.27; p<0.001) had increased risk of mortality. Compared with other or unknown mechanisms, penetrating injuries also had increased risk of mortality (1.46, 95% CI 1.17 to 1.81, p=0.001). Alcohol use was associated with a lower risk of mortality (0.54, 95% CI 0.39 to 0.75; p<0.001). <br><br>DISCUSSION: Even in a sub-Saharan country that never experienced internal collective violence, IPV injury rates are high. Public health efforts to measure and address alcohol use, and studies to determine the role of &quot;mob justice,&quot; poverty, and intimate partner violence in IPV, in Malawi are needed. LEVEL OF EVIDENCE: Level III.<p /> <p>Language: en</p>",
language="en",
issn="2397-5776",
doi="10.1136/tsaco-2018-000252",
url="http://dx.doi.org/10.1136/tsaco-2018-000252"
}