Suicide in Brazilian indigenous communities: clustering of cases in children and adolescents by household

Autores

  • Thomas Adriano Lazzarini Yale University. School of Medicine
  • Crhistinne Cavalheiro Maymone Gonçalves Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina
  • Walter Martins Benites Distrito Sanitário Especial Indígena. Polo Base Dourados
  • Liliane Ferreira da Silva Distrito Sanitário Especial Indígena. Polo Base Dourados
  • Daniel Henrique Tsuha Universidade Federal de Mato Grosso do Sul. Faculdade de Computação
  • Albert Icksang Ko Yale University. School of Medicine
  • Robert Rohrbaugh Yale University. School of Medicine
  • Jason Randolph Andrews Stanford University School of Medicine. Division of Infectious Diseases and Geographic Medicine.
  • Julio Croda Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina Fundação Oswaldo Cruz

DOI:

https://doi.org/10.11606/S1518-8787.2018052000541

Palavras-chave:

Suicide. Child. Adolescent. Health of Indigenous Peoples. Mental Health. Health Vulnerability. Cohort Studies.

Resumo

OBJECTIVE: To estimate age and sex-specific suicide rates, compare suicide rates between indigenous communities, and quantify the frequency of intrafamilial suicide clustering. METHODS: We performed a retrospective cohort study involving 14,666 indigenous individuals in reservations in Dourados, state of Mato Grosso do Sul, Brazil, from 2003 through 2013 using national and local census. RESULTS: The overall suicide rate was 73.4 per 100,000 person-years. Adolescent males aged 15–19 and girls aged 10–14 had the highest rates for each sex at 289.3 (95%CI 187.5–391.2) and 85.3 (95%CI 34.9–135.7), respectively. Comparing the largest reservations, Bororo had a higher suicide rate than Jaguapiru (RR = 4.83, 95%CI 2.85–8.16) and had significantly lower socioeconomic indicators including income and access to electricity. Nine of 19 suicides among children under 15 occurred in household clusters. Compared with adult suicides, a greater proportion of child (OR = 5.12, 95%CI 1.89–13.86, p = 0.001) and adolescent (OR = 3.48, 95%CI 1.29–9.44, p = 0.017) suicides occurred within household clusters. CONCLUSIONS: High rates of suicide occur among children and adolescents in these indigenous reservations, particularly in poor communities. Nearly half of child suicides occur within household clusters. These findings underscore the need for broad public health interventions and focused mental health interventions in households following a suicide.

Publicado

2018-05-08

Edição

Seção

Artigos Originais

Como Citar

Lazzarini, T. A., Gonçalves, C. C. M., Benites, W. M., Silva, L. F. da, Tsuha, D. H., Ko, A. I., Rohrbaugh, R., Andrews, J. R., & Croda, J. (2018). Suicide in Brazilian indigenous communities: clustering of cases in children and adolescents by household. Revista De Saúde Pública, 52, 56. https://doi.org/10.11606/S1518-8787.2018052000541