Abstract
BackgroundSuicide accounts for approximately 1.4% of deaths globally and is the 15th leading cause of death overall. There are no reliable data on the epidemiology of completed suicide in rural areas of many developing countries, yet suicide is an indicator of the sustainable development goals on health.MethodsUsing data collected between 2008 and 2016 from the Kilifi Health and Demographic Surveillance System in rural Kenya, we retrospectively determined the incidence rate and risk factors for completed suicide.ResultsDuring the period, 104 people died by suicide, contributing to 0.78% (95% CI = 0.74–1.10) of all deaths. The mean annual incidence rate of suicide was 4.61 (95% CI = 3.80–5.58) per 100,000 person years of observation (pyo). The annual incidence rate for men was higher than that of women (IRR = 3.05, 95% CI = 1.98–4.70, p < 0.001) and it increased with age (IRR = 2.73, 95% CI = 2.30–3.24, p < 0.001). People aged > 64 years had the highest mean incidence rate of 18.58 (95% CI = 11.99–28.80) per 100,000 pyo. Completed suicide was associated with age, being male, and living in a house whose wall is made of scrap material, which is a proxy marker of extreme poverty in this region (OR = 5.5, 95% CI = 4.0–7.0, p = 0.02). Most cases (76%) completed suicide by hanging themselves. Spatial heterogeneity of rates of suicides was observed across the enumeration zones of the KHDSS.ConclusionsSuicide is common in this area, but the incidence of completed suicide in rural Kenya may be an underestimate of the true burden. Like in other studies, suicide was associated with older age, being male and poverty, but other medical and neuropsychiatric risk factors should be investigated in future studies.
Highlights
Suicide accounts for approximately 1.4% of deaths globally and is the 15th leading cause of death overall
Studies have shown a link between suicide and mental and physical health, which may have motivated the inclusion of suicide as an indicator for Sustainable Development Goals (SDG) whose aim is to reduce premature mortality from non-communicable diseases
Sociodemographic characteristics and morbidity data of people who died by suicide Between 2008 and 2016, 13,316 people within the Kilifi Health and Demographic Surveillance System (KHDSS) died, of whom 104 were suicide cases, contributing to 0.78% of all deaths in the KHDSS during this period
Summary
Suicide accounts for approximately 1.4% of deaths globally and is the 15th leading cause of death overall. There are no reliable data on the epidemiology of completed suicide in rural areas of many developing countries, yet suicide is an indicator of the sustainable development goals on health. According to the World Health Organization’s (WHO) 2014 World Report on Suicide, approximately 75% of suicides occur in low and middle-income countries. There have been efforts towards this imperative by low and middle income countries such as Kenya which have initiated campaigns to decriminalize suicide with the aim of encouraging suicide attempters to seek help [6]. Such efforts may result in underreporting of suicide cases in Kenya in fear of prosecution. Suicide related acts are illegal in Kenya according to penal code
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