The epidemiology of major incidents in the Western Cape Province, South Africa.

Background: Major incidents put pressure on any health system. There are currently no studies describing the epidemiology of major incidents in South Africa (SA). The lack of data makes planning for major incidents and exercising of major incident plans difficult.
Objective: To describe the epidemiology of major incidents in the Western Cape Province, SA.
Methods: A retrospective analysis of the Western Cape Major Incident database was conducted for the period 1 December 2008-30 June 2014. Variables collected related to patient demographics and incident details. Summary statistics were used to describe all variables.
Results: Seven hundred and seventy-seven major incidents were reviewed (median n=11 per month). Most major incidents occurred in the City of Cape Town (57.8%, n=449), but the Central Karoo district had the highest incidence (11.97/10 000 population). Transport-related incidents occurred most frequently (94.0%, n=730). Minibus taxis were involved in 312 major incidents (40.2%). There was no significant difference between times of day when incidents occurred. A total of 8,732 patients were injured (median n=8 per incident); ten incidents involved 50 or more victims. Most patients were adults (80.0%, n=6 986) and male (51.0%, n=4,455). Of 8,440 patients, 630 (7.5%) were severely injured. More than half of the patients sustained minor injuries (54.6%, n=4,605).
Conclusion: Major incidents occurred more often than would have been expected compared with other countries, with road traffic crashes the biggest contributor. A national database will provide a better perspective of the burden of major incidents.