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Am J Public Health. 2014 Nov;104(11):e54-61. doi: 10.2105/AJPH.2014.302191. Epub 2014 Sep 11.

A systematic review of the epidemiology of nonfatal strangulation, a human rights and health concern.

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Susan B. Sorenson is with the School of Social Policy and Practice and the Center for Public Health Initiatives at the University of Pennsylvania, Philadelphia. Manisha Joshi is with the School of Social Work at the University of South Florida, Tampa. At the time this study was conducted, Elizabeth Sivitz was a student at the School of Arts and Sciences at the University of Pennsylvania.


We reviewed the literature on the epidemiology of nonfatal strangulation (also, albeit incorrectly, called choking) by an intimate partner. We searched 6 electronic databases to identify cross-sectional, primary research studies from 1960 to 2014 that reported national prevalence estimates of nonfatal strangulation by an intimate partner among community-residing adults. Of 7260 identified references, 23 articles based on 11 self-reported surveys in 9 countries met the inclusion criteria. The percentage of women who reported ever having been strangled by an intimate partner ranged from 3.0% to 9.7%; past-year prevalence ranged from 0.4% to 2.4%, with 1.0% being typical. Although many epidemiological surveys inquire about strangulation, evidence regarding its prevalence is scarce. Modifying or adding a question to ongoing national surveys, particularly the Demographic and Health Surveys, would remedy the lack of data for low- and middle-income countries. In addition, when questions about strangulation are asked, findings should be reported rather than only combined with other questions to form broader categories (e.g., severe violence). Such action is merited because of the multiple negative short- and long-term sequelae of strangulation.

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