ABSTRACT
Background: Suicidal behaviour is a leading contributor to the burden of disease worldwide and varies widely between countries. South African figures are amongst the highest in the world; with recent trends indicating a disturbing rise; especially amongst the younger age groups; across all races. Aim: This study analysed sociodemographic characteristics and trends relating to suicides committed in Durban; South Africa during the period of 2006-2007. Method: A retrospective analysis of suicidal deaths (during 2006-2007); extracted from autopsy registers at all three government-run mortuaries in Durban; was conducted. Results: The total number of suicides in Durban increased by 6.68 from 2006 to 2007. Suicide accounted for an average of 8.8 of all non-natural deaths per year of the study. The overall suicide rates of 14.53 (2006) and 15.53 (2007) per 100 000 population are comparable with national and global figures. The majority of suicides occurred in single unemployed persons; men and younger age groups. The largest number of suicides per year was recorded in black people; followed by Indian; white and mixed-race people. Hanging was the preferred method in the majority of victims; followed by self-poisoning; shooting and jumping. Conclusions: The findings indicate a disturbingly high suicide rate amongst the various population and age groups in Durban. The dominant methods used may be influenced by ease of access. The reported trends may worsen unless there is a swift and decisive public health response and cohesive community-based programmes which include a supportive multidisciplinary network
Subject(s)
Population Characteristics , Retrospective Studies , Socioeconomic Factors , South Africa , Suicide/statistics & numerical dataABSTRACT
Background: Depressive disorders are associated with poorer health outcomes in people living with human immunodeficiency virus infection and acquired immunodeficiency syndrome (PLHIV) and have been shown to contribute to non-adherence to antiretroviral therapy (ART) in Western contexts. Limited data from developing countries are available. The aim of this study was to explore whether there was an association between depressive symptoms and adherence to ART among PLHIV in KwaZulu-Natal; South Africa.Method: A cross-sectional analytical study was undertaken in a population of HIV-positive patients accessing ART at a government funded; semi-urban clinic in the eThekwini Municipal District; KwaZulu-Natal; South Africa. The tools used to measure depressive symptoms and adherence were the Centre for Epidemiology Studies Depression Scale (CES-D) and clinic-based pill counts; respectively. Socio-demographic and clinical data were collected during interviews and from patient records.Results: Sixty-two per cent of the sample (n = 146) had higher-than-threshold levels on the depression scale; and 32 were less than 95 adherent to ART. High depression scores were associated with lower levels of education [odds ratio (OR) 2.0; 95 confidence interval (CI); 1.0-4.1] and unemployment (OR 2.8; 95 CI; 1.3-6.0); while non-adherence was associated with unemployment (OR 2.4; 95 CI; 1.0-6.1) and mid-range CD4 counts (200-499 cells/?l; OR 3.0; 95 CI; 1.3-6.9). No significant association was found between depressive symptoms and non-adherence to ART (OR 0.5; 95 CI; 0.2-1.2; p-value; 0.125).Conclusion: The large percentage of participants who scored high on the CES-D suggests a high prevalence of major depression in the study population. No significant association was found between high depression scores and nonadherence to ART. Depressive symptoms were significantly linked to lower levels of education and unemployment; while non-adherence was associated with unemployment and mid-range CD4 counts (200-499 cells/?l). The study had some limitations. Further studies are needed to determine the prevalence and causes of depression and its impact on PLHIV in this population and in the developing world