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Suicide attempts captured in two emergency departments - Nicaragua 2001- 2002.

Mercado-O; Rocha-J; Martinez-M; Noe-R; Clavel-C
The 7th World Conference on Injury Prevention and Safety Promotion, Vienna, Austria, June 6th-9th 2004. Vienna, Austria: Kuratorium für Schutz und Sicherheit/Institut Sicher Leben, 2004 Jun; :500-501
Problem under study: In Nicaragua, the suicide rates were estimated (is this his meaning w/raw appraisals) in 1992 to be 7.7 and 2.8 in 2002 both for 100,000 inhabitant. According to the Ministry of Health in 2000, suicide became the leading cause of death in the age group 15 to 34 years. The easy access to lethal methods like pesticides and a popular culture which romanticizes suicide has produced an "Epidemic Buds of Suicides " The Nicaraguan Ministry of Health, in collaboration with the Pan American Health Organization and the Centers for Disease Control and Prevention have implemented an emergency department (ED) based injury surveillance system and this was the study's data source. Objectives: To describe epidemiologically suicide attempts and suicides captured in two emergency departments (ED) in Nicaragua; with the purpose of designing preventing strategies. Methodology: Through the injury surveillance system suicides both attempted and completed were captured in two hospitals: Hospital Antonio Lenin Fonseca in the capital Managua and a rural hospital, Santiago in Jinotepe. The study period was August, 1, 2001 July 31, 2002 . The data were analyzing using EPI Info 2002 software. The variables analyzed were: age, sex, occupation, place, mechanism, object and precipitators factors. Results: In total there were 101,138 emergency consultations seen in both hospitals, of these 27% (n= 27,482) were injuries. The majority were non intentional (74 % or n= 20.223) followed by 19% (n=5.142) being related to interpersonal violence and with self-inflicted 1. This ED based injury surveillance system identified1 % ( n= 314 ). Of the 314 self-inflicted 25 completed suicide .The lethality rate for self-inflicted was 8 % . In Hospital Lenin Fonseca there were 246 attempted suicides with 23 completions (9.3% lethality), Hospital Regional Santiago has 69 attempts and 2 recorded as completed (2.9% (lethality). For both hospitals, females under 24 years old attempted suicide more often than males yet for males between ages 20-24 and older than 65 their numbers of completion were higher. Of those with self-inflicted injury, there were students 91 (29%), housewives 93 (30%), workers 58 (18.5%), farmers 18 (6.1%), technicians 17 (5.4%) and professionals and merchants 10 (3%), respectively. The main mechanism was poisoning, drugs 118 (45.4%); pesticide 60 (23%). 28 people used aluminum fire, "other" methods 82 (31.5%), cut 34 (10.8%), strangled 10 (3.2%), weapons 5 (1.6%), or jump of a level to another 1 (0.3%).. Precipitators factors were family conflict 144 (46.3%), psychological problems 35 (11.3%), justice problems 4 (1.3%), family death and physical illness 3 (1%) financial problems 2 (0.6%), another 25 (8%), and unknown 95 (31%). Conclusion: This ED based injury surveillance system identified specific age and gender groups of suicide attempts, amongst them females below 24 years, and males and females over 65. Another risk factor identified was easy access to pesticides; as well family conflict was the most precipitating factor. Based on these data a special program to prevent self-inflicted injuries was setup at two municipalities with the support from the mayor health authorities. Moreover, a task group to follow-up the program was established. From its launching it had received a great deal of attention form the media and the community at large.
Surveillance-programs; Statistical-analysis; Epidemiology; Demographic-characteristics; Pesticides; Pesticides-and-agricultural-chemicals; Psychological-disorders; Psychological-factors; Mental-illness; Mental-health; Sex-factors
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The 7th World Conference on Injury Prevention and Safety Promotion, Vienna Austria, June 6th-9th 2004