Abstract
While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14–24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were recruited for a 30-minute interviewer-administered survey through eight drop-in centers operated by the Uganda Youth Development Link for youth in need of services. Bivariate and multivariate logistic regression analyses were computed to determine associations between psychosocial correlates and suicide ideation and suicide attempt. Reporting both parents deceased Adj.OR = 2.36; 95% CI: 1.23–4.52), parental neglect due to alcohol use (Adj.OR = 2.09; 95% CI: 1.16–3.77), trading sex for food, shelter or money (Adj.OR = 1.95; 95% CI: 1.09–3.51), sadnesss (Adj.OR = 2.42; 95% CI: 1.20–4.89), loneliness (Adj.OR = 2.67; 95% CI: 1.12–6.40) and expectations of dying prior to age 30 (Adj.OR = 2.54; 95% CI: 1.53–4.23) were significantly associated with suicide ideation in multivariate analyses. Parental neglect due to alcohol use (Adj.OR = 2.04; 95% CI: 1.11–3.76), sadness (Adj.OR = 2.42; 95% CI: 1.30–7.87), and expectations of dying prior to age 30 (Adj.OR = 2.18; 95% CI: 1.25–3.79) were significantly associated with suicide attempt in multivariate analyses. Given the dire circumstances of this vulnerable population, increased services and primary prevention efforts to address the risk factors for suicidal behavior are urgently needed.
Highlights
Every year, almost one million people die from suicide; a global mortality rate of 16 per 100,000, or one death every 40 seconds [1] and as such it is a critically important public health problem [2].Suicide is the fourth leading cause of death globally among youth 15 to 19 years of age [3] and the tenth leading cause for adolescents 10–14 years of age [4]
Studies conducted in Nigeria [8], South Africa [9], Zambia [10], and Uganda [5,11] indicate that suicidal behavior is relatively common, and varies across countries [12]
The high levels of suicidal ideation and behavior among youth in sub-Saharan Africa have likely been exacerbated by the severe psychosocial stress and other adverse health outcomes associated with the high prevalence of HIV/AIDS in Africa [2] as well as scarce food supply [14] and other distressing circumstances
Summary
Suicide is the fourth leading cause of death globally among youth 15 to 19 years of age [3] and the tenth leading cause for adolescents 10–14 years of age [4]. These figures do not include suicide attempts, which are up to 20 times more frequent than completed suicide [1]. The high levels of suicidal ideation and behavior among youth in sub-Saharan Africa have likely been exacerbated by the severe psychosocial stress and other adverse health outcomes associated with the high prevalence of HIV/AIDS in Africa [2] as well as scarce food supply [14] and other distressing circumstances. The stigma, discrimination, isolation, lack of support from family and friends, loss of parents or family members from HIV/AIDS further increases the risk of suicidal behavior [7]
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