Dataset Information

Trends in Suicide Mortality in South Africa, 1997 to 2016.

ABSTRACT: Suicide rates worldwide are declining; however, less is known about the patterns and trends in mortality from suicide in sub-Saharan Africa. This study evaluates trends in suicide rates and years of potential life lost from death registration data in South Africa from 1997 to 2016. Suicide (X60-X84 and Y87) was coded using the 10th Revision of the International Classification of Diseases (ICD-10). Changes in mortality rate trends were analysed using joinpoint regression analysis. The 20-year study examines 8573 suicides in South Africa, comprising 0.1% of all deaths involving persons 15 years and older. Rates of suicide per 100,000 population were 2.07 in men and 0.49 in women. Joinpoint regression analyses showed that, while the overall mortality rate for male suicides remained stable, mortality rates due to hanging and poisoning increased by 3.9% and 3.5% per year, respectively. Female suicide mortality rates increased by 12.6% from 1997 to 2004 before stabilising; while rates due to hanging increased by 3.0% per year. The average annual YPLL due to suicide was 9559 in men and 2612 in women. The results show that suicide contributes substantially to premature death and demonstrates the need for targeted interventions, especially among young men in South Africa.

SUBMITTER: Kootbodien T

PROVIDER: S-EPMC7142470 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Trends in Suicide Mortality in South Africa, 1997 to 2016.

Kootbodien Tahira T Naicker Nisha N Wilson Kerry S KS Ramesar Raj R London Leslie L

International journal of environmental research and public health 20200312 6

Suicide rates worldwide are declining; however, less is known about the patterns and trends in mortality from suicide in sub-Saharan Africa. This study evaluates trends in suicide rates and years of potential life lost from death registration data in South Africa from 1997 to 2016. Suicide (X60-X84 and Y87) was coded using the 10th Revision of the International Classification of Diseases (ICD-10). Changes in mortality rate trends were analysed using joinpoint regression analysis. The 20-year stu ...[more]

PMID: 32178393

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Project description:BackgroundTwo World Health Organization comparative assessments rated the quality of South Africa's 1996 mortality data as low. Since then, focussed initiatives were introduced to improve civil registration and vital statistics. Furthermore, South African cause-of-death data are widely used by research and international development agencies as the basis for making estimates of cause-specific mortality in many African countries. It is hence important to assess the quality of more recent South African data.MethodsWe employed nine criteria to evaluate the quality of civil registration mortality data. Four criteria were assessed by analysing 5.38 million deaths that occurred nationally from 1997-2007. For the remaining five criteria, we reviewed relevant legislation, data repositories, and reports to highlight developments which shaped the current status of these criteria.FindingsNational mortality statistics from civil registration were rated satisfactory for coverage and completeness of death registration, temporal consistency, age/sex classification, timeliness, and sub-national availability. Epidemiological consistency could not be assessed conclusively as the model lacks the discriminatory power to enable an assessment for South Africa. Selected studies and the extent of ill-defined/non-specific codes suggest substantial shortcomings with single-cause data. The latter criterion and content validity were rated unsatisfactory.ConclusionIn a region marred by mortality data absences and deficiencies, this analysis signifies optimism by revealing considerable progress from a dysfunctional mortality data system to one that offers all-cause mortality data that can be adjusted for demographic and health analysis. Additionally, timely and disaggregated single-cause data are available, certified and coded according to international standards. However, without skillfully estimating adjustments for biases, a considerable confidence gap remains for single-cause data to inform local health planning, or to fill gaps in sparse-data countries on the continent. Improving the accuracy of single-cause data will be a critical contribution to the epidemiologic and population health evidence base in Africa.

Project description:BACKGROUND:Measuring and monitoring progress towards Millennium Development Goals (MDG) 4 and 5 required valid and reliable estimates of maternal and child mortality. In South Africa, there are conflicting reports on the estimates of maternal and neonatal mortality, derived from both direct and indirect estimation techniques. This study aimed to systematically review the estimates made of maternal and neonatal mortality in the period from 1990 to 2015 in South Africa and determine trends over this period. METHODS:Nationally-representative studies reporting on maternal and neonatal mortality in South Africa were included for synthesis. Literature search for eligible studies was conducted in five electronic databases: Medline, Africa-Wide Information, Scopus, Web of Science and CINAHL. Searches were restricted to articles written in English and presenting data covering the period between 1990 and 2015. Reference lists of retrieved articles were screened for additional publications, and grey literature was searched for relevant documents for the review. Three independent reviewers were involved in study selection, data extractions and achieving consensus. RESULTS:In total, 969 studies were retrieved and 670 screened for eligibility yielding 25 studies reporting data on maternal mortality and 14 studies on neonatal mortality. Most of the studies had a low risk of bias. Estimates from the institutional reporting differed from the international metrics with wide uncertainty/confidence intervals. Moreover, modelled estimates were widely divergent from estimates obtained through empirical methods. In the last two decades, both maternal and neonatal mortality appear to have increased up to 2009, followed by a decrease, more pronounced in the care of maternal mortality. CONCLUSION:Estimates from both global metrics and institutional reporting, although widely divergent, indicate South Africa has not achieved MDG 4a and 5a goals but made a significant progress in reducing maternal and neonatal mortality. To obtain more accurate estimates, there is a need for applying additional estimation techniques which utilise available multiple data sources to correct for underreporting of these outcomes, perhaps the capture-recapture method. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42016042769.

Dataset Information

Trends in Suicide Mortality in South Africa, 1997 to 2016.

Publications

Trends in Suicide Mortality in South Africa, 1997 to 2016.

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