Fatality of suicide attempts in Amsterdam 1996-2005.

BACKGROUND: According to recent figures, Amsterdam is the municipality with the highest absolute number of suicides and the second highest suicide rate in the Netherlands. AIMS: The aim of the study was to identify time trends and demographic differences in the occurrence of nonfatal suicide attempts versus suicides. METHODS: We used registrations of forensic physicians and ambulance services of the Municipal Health Service of Amsterdam to study 1,004 suicides and 6,166 nonfatal attempts occurring in Amsterdam over the period 1996-2005. RESULTS: The number of nonfatal attempts declined from 1996 to 2005, but the number of completed suicides remained relatively stable. Although case fatality was strongly associated with method used, we also found higher case fatalities for men and older people independent of method. CONCLUSIONS: The case fatality results suggest differences in motive among different demographic groups: possibly the wish to die is stronger among men and elderly. This finding had implications for the success to be expected from different preventive measures.

An eye for inequality: how trachoma relates to poverty in Tanzania and Vietnam.

PURPOSE: An important challenge for trachoma control strategies is to break the circle of poverty, poor hygiene and poor health by bringing its benefits to the poor. This article aims to assess to what extent trachoma is a disease of the poor, and trachoma services reach the poor in Tanzania and Vietnam. METHODS: Individual level data on trachoma prevalence (active trachoma and trichiasis) and utilization of trachoma-related services were collected in both countries in 2004. Prevalence data were also available for Vietnam in 2001. We used household level data to construct an asset index as our living standards measure. Next, we related trachoma prevalence and service use to living standards, and used concentration indices to summarize and test the degree of inequality. RESULTS: Trachoma prevalence was higher among the poorest groups in Tanzania. No such relation could be established in Vietnam where prevalence declined over the period 2001-2004 and particularly so among the least poor. Antibiotics were used more by the poorest in Tanzania and by the less poor in Vietnam. In both countries, there was no unequivocal pattern for the relation between living standards and the use of trachoma services. CONCLUSIONS: Trachoma is found to be a disease of the poorest in Tanzania, but not in Vietnam. In the latter country there are indications that district characteristics have an important impact on trachoma prevalence. The higher use of antibiotics among the better-off in Vietnam may have contributed to their larger decline in active trachoma prevalence between 2001 and 2004 compared to the poorer segments.