The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Area and Population
2.2. Questionnaire and Data Collection
2.3. Statistical Method and Analyses
2.4. Ethical Statement
3. Results
4. Discussion
Limitations and Challenges
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
LMIC | Low and Middle Income Countries |
HIC | High Income Countries |
CIPRB | Center for Injury Prevention and Research, Bangladesh |
icddr,b | International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) |
JHSPH | John’s Hopkins School of Public Health |
CI | Confidence Interval |
IRR | Incidence Rate Ratio |
PYO | Person Years Observed |
References
- WHO Estimates for 2000–2012. Available online: http://www.who.int/healthinfo/global_burden_disease/estimates/en/ (accessed on 12 July 2016).
- WHO Preventing Suicide: A Global Imperative. Available online: http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/ (accessed on 12 July 2016).
- WHO Disease and Injury Country Estimates. Available online: http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/ (accessed on 7 July 2016).
- Värnik, P. Suicide in the World. Int. J. Environ. Res. Public Health 2012, 9, 760–771. [Google Scholar] [CrossRef] [PubMed]
- Chen, Y.Y.; Wu, K.C.C.; Yousuf, S.; Yip, P.S.F. Suicide in Asia: Opportunities and Challenges. Epidemiol. Rev. 2012, 34, 129–144. [Google Scholar] [CrossRef] [PubMed]
- The WHO World Mental Health Surveys-Cambridge University Press. Available online: http://www.cambridge.org/catalogue/catalogue.asp?isbn=9780521884198 (accessed on 7 July 2016).
- Jordans, M.J.; Kaufman, A.; Brenman, N.F.; Adhikari, R.P.; Luitel, N.P.; Tol, W.A.; Komproe, I. Suicide in South Asia: A Scoping Review. BMC Psychiatry 2014, 14, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Wang, C.W.; Chan, C.L.W.; Yip, P.S.F. Suicide Rates in China from 2002 to 2011: An Update. Soc. Psychiatry Psychiatr. Epidemiol. 2014, 49, 929–941. [Google Scholar] [CrossRef] [PubMed]
- Patel, V.; Ramasundarahettige, C.; Vijayakumar, L.; Thakur, J.; Gajalakshmi, V.; Gururaj, G.; Suraweera, W.; Jha, P. Suicide Mortality in India: A Nationally Representative Survey. Lancet 2012, 379, 2343–2351. [Google Scholar] [CrossRef]
- Mashreky, S.R.; Rahman, F.; Rahman, A. Suicide Kills More Than 10,000 People Every Year in Bangladesh. Arch. Suicide Res. 2013, 17, 387–396. [Google Scholar] [CrossRef] [PubMed]
- GHO by Category Suicide Rates-Data by Country. Available online: http://apps.who.int/gho/data/view.main.MHSUICIDEv (accessed on 7 July 2016).
- Alam, N.; Chowdhury, H.R.; Das, S.C.; Ashraf, A.; Streatfield, P.K. Causes of Death in Two Rural Demographic Surveillance Sites in Bangladesh, 2004–2010: Automated Coding of Verbal Autopsies Using InterVA-4. Glob. Health Action 2014. [Google Scholar] [CrossRef] [PubMed]
- Nahar, Q.; Arifeen, S.E.; Jamil, K.; Streatfield, P.K. Causes of Adult Female Deaths in Bangladesh: Findings from Two National Surveys. BMC Public Health 2015. [Google Scholar] [CrossRef] [PubMed]
- Hyder, A.A.; Alonge, O.; He, S.; Wadhwaniya, S.; Rahman, F.; Rahman, A.; Arifeen, S.E. Saving of Children’s Lives from Drowning Project in Bangladesh. Am. J. Prev. Med. 2014, 47, 842–845. [Google Scholar] [CrossRef] [PubMed]
- Hyder, A.A.; Alonge, O.; He, S.; Wadhwaniya, S.; Rahman, F.; Rahman, A.; Arifeen, S.E. A Framework for Addressing Implementation Gap in Global Drowning Prevention Interventions: Experiences from Bangladesh. J. Health Popul. Nutr. 2014, 32, 564–576. [Google Scholar] [PubMed]
- Alonge, O.; Agarwal, P.; Taleb, A.; Rahman, Q.; Rahman, A.F.; Arifeen, S.E.; Hyder, A. Fatal and Non-Fatal Injury Outcomes: Results from a Purposively Sampled Census of Seven Rural Sub-Districts in Bangladesh. Lancet Glob. Health 2017, 5, 818–827. [Google Scholar] [CrossRef]
- Fontanella, C.A.; Hiance-Steelesmith, D.L.; Phillips, G.S.; Bridge, J.A.; Lester, N.; Sweeney, H.A.; Campo, J.V. Widening Rural-Urban Disparities in Youth Suicides, United States, 1996–2010. JAMA Pediatr. 2015, 169, 466–473. [Google Scholar] [CrossRef] [PubMed]
- Hirsch, J.K. A Review of the Literature on Rural Suicide: Risk and Protective Factors, Incidence, and Prevention. Crisis 2006, 27, 189–199. [Google Scholar] [CrossRef] [PubMed]
- Judd, F.; Cooper, A.M.; Fraser, C.; Davis, J. Rural Suicide—People or Place Effects? Aust. N.Z. J. Psychiatry 2006, 40, 208–216. [Google Scholar] [PubMed]
- Möller-Leimkühler, A.M. The Gender Gap in Suicide and Premature Death or: Why Are Men so Vulnerable? Eur. Arch. Psychiatry Clin. Neurosci. 2003, 253, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Chau, K.; Kabuth, B.; Chau, N. Gender and Family Disparities in Suicide Attempt and Role of Socioeconomic, School, and Health-Related Difficulties in Early Adolescence. BioMed Res. Int. 2014, 2014, 1–13. [Google Scholar] [CrossRef] [PubMed]
- Aggarwal, S. Suicide in India. Br. Med. Bull. 2015, 114, 127–134. [Google Scholar] [CrossRef] [PubMed]
- Parker, G.; Yap, H.L. Suicide in Singapore: A Changing Sex Ratio over the Last Decade. Singap. Med. J. 2001, 42, 11–14. [Google Scholar]
- Hadi, A. Risk Factors of Violent Death in Rural Bangladesh, 1990–1999. Death Stud 2005, 29, 559–572. [Google Scholar] [CrossRef] [PubMed]
- Yusuf, H.R.; Akhter, H.H.; Chowdhury, M.E.; Rochat, R.W. Causes of Death among Women Aged 10–50 Years in Bangladesh, 1996–1997. J. Health Popul. Nutr. 2007, 25, 302–311. [Google Scholar] [PubMed]
- Gipson, J.D.; Hicks, A.L.; Gultiano, S.A. Gendered Differences in the Predictors of Sexual Initiation among Young Adults in Cebu, Philippines. J. Adolesc. Health Off. Publ. Soc. Adolesc. Med. 2014, 54, 599–605. [Google Scholar] [CrossRef] [PubMed]
- Silenzio, V.M.B.; Pena, J.B.; Duberstein, P.R.; Cerel, J.; Knox, K.L. Sexual Orientation and Risk Factors for Suicidal Ideation and Suicide Attempts Among Adolescents and Young Adults. Am. J. Public Health 2007, 97, 2017–2019. [Google Scholar] [CrossRef] [PubMed]
- Masocco, M.; Pompili, M.; Vichi, M.; Vanacore, N.; Lester, D.; Tatarelli, R. Suicide and Marital Status in Italy. Psychiatr. Q. 2008, 79, 275–285. [Google Scholar] [CrossRef] [PubMed]
- Corcoran, P.; Nagar, A. Suicide and Marital Status in Northern Ireland. Soc. Psychiatry Psychiatr. Epidemiol. 2009, 45, 795–800. [Google Scholar] [CrossRef] [PubMed]
- Cutright, P.; Stack, S.; Fernquist, R. Marital Status Integration, Suicide Disapproval, and Societal Integration as Explanations of Marital Status Differences in Female Age-Specific Suicide Rates. Suicide Life Threat. Behav. 2007, 37, 715–724. [Google Scholar] [CrossRef] [PubMed]
- Lorant, V.; Kunst, A.E.; Huisman, M.; Bopp, M.; Mackenbach, J. A European Comparative Study of Marital Status and Socio-Economic Inequalities in Suicide. Soc. Sci. Med. 2005, 60, 2431–2441. [Google Scholar] [CrossRef] [PubMed]
- Khan, M.M. Suicide on the Indian Subcontinent. Crisis 2002, 23, 104–107. [Google Scholar] [CrossRef] [PubMed]
- Khan, M.M. Suicide Prevention and Developing Countries. J. R. Soc. Med. 2005, 98, 459–463. [Google Scholar] [CrossRef] [PubMed]
- Naved, R.T.; Akhtar, N. Spousal Violence against Women and Suicidal Ideation in Bangladesh. Womens Health Issues 2008, 18, 442–452. [Google Scholar] [CrossRef] [PubMed]
- Devries, K.; Watts, C.; Yoshihama, M.; Kiss, L.; Schraiber, L.B.; Deyessa, N.; Heise, L.; Durand, J.; Mbwambo, J.; Jansen, H.; et al. Violence against Women Is Strongly Associated with Suicide Attempts: Evidence from the WHO Multi-Country Study on Women’s Health and Domestic Violence against Women. Soc. Sci. Med. 2011, 73, 79–86. [Google Scholar] [CrossRef] [PubMed]
- Pico-Alfonso, M.A.; Garcia-Linares, M.I.; Celda-Navarro, N.; Blasco-Ros, C.; Echeburúa, E.; Martinez, M. The Impact of Physical, Psychological, and Sexual Intimate Male Partner Violence on Women’s Mental Health: Depressive Symptoms, Posttraumatic Stress Disorder, State Anxiety, and Suicide. J. Womens Health 2006, 15, 599–611. [Google Scholar] [CrossRef] [PubMed]
- Seedat, S.; Stein, M.B.; Forde, D.R. Association between Physical Partner Violence, Posttraumatic Stress, Childhood Trauma, and Suicide Attempts in a Community Sample of Women. Violence Vict. 2005, 20, 87–98. [Google Scholar] [CrossRef] [PubMed]
- Sudhir Kumar, C.T.; Mohan, R.; Ranjith, G.; Chandrasekaran, R. Gender Differences in Medically Serious Suicide Attempts: A Study from South India. Psychiatry Res. 2006, 144, 79–86. [Google Scholar] [CrossRef] [PubMed]
- Maselko, J.; Patel, V. Why Women Attempt Suicide: The Role of Mental Illness and Social Disadvantage in a Community Cohort Study in India. J. Epidemiol. Community Health 2008, 62, 817–822. [Google Scholar] [PubMed]
- Hawton, K.; Saunders, K.E.; O’Connor, R.C. Self-Harm and Suicide in Adolescents. Lancet 2012, 379, 2373–2382. [Google Scholar] [CrossRef]
- Pitman, A.; Krysinska, K.; Osborn, D.; King, M. Suicide in Young Men. Lancet 2012, 379, 2383–2392. [Google Scholar] [CrossRef]
- Séguin, M.; Renaud, J.; Lesage, A.; Robert, M.; Turecki, G. Youth and Young Adult Suicide: A Study of Life Trajectory. J. Psychiatr. Res. 2011, 45, 863–870. [Google Scholar] [CrossRef] [PubMed]
- Yip, P.S.; Caine, E.; Yousuf, S.; Chang, S.S.; Wu, K.C.C.; Chen, Y.Y. Means Restriction for Suicide Prevention. Lancet 2012, 379, 2393–2399. [Google Scholar] [CrossRef]
- Bálint, L.; Osváth, P.; Rihmer, Z.; Döme, P. Associations between Marital and Educational Status and Risk of Completed Suicide in Hungary. J. Affect. Disord. 2016, 190, 777–783. [Google Scholar] [CrossRef] [PubMed]
- Poorolajal, J.; Rostami, M.; Mahjub, H.; Esmailnasab, N. Completed Suicide and Associated Risk Factors: A Six-Year Population Based Survey. Arch. Iran. Med. 2015, 18, 39–43. [Google Scholar] [PubMed]
- Florentine, J.B.; Crane, C. Suicide Prevention by Limiting Access to Methods: A Review of Theory and Practice. Soc. Sci. Med. 2010, 70, 1626–1632. [Google Scholar] [CrossRef] [PubMed]
- Wu, K.C.C.; Chen, Y.Y.; Yip, P.S.F. Suicide Methods in Asia: Implications in Suicide Prevention. Int. J. Environ. Res. Public Health 2012, 9, 1135–1158. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Milner, A.; De Leo, D. Suicide Research and Prevention in Developing Countries in Asia and the Pacific. Bull. World Health Organ. 2010, 88, 795–796. [Google Scholar] [CrossRef] [PubMed]
- WHO Reducing Access to Means of Suicide. Available online: http://www.who.int/mental_health/mhgap/evidence/suicide/q7/en/ (accessed on 7 July 2016).
- Nordentoft, M. Crucial Elements in Suicide Prevention Strategies. Prog. Neuropsychopharmacol. Biol. Psychiatry 2011, 35, 848–853. [Google Scholar] [CrossRef] [PubMed]
- Gunnell, D.; Fernando, R.; Hewagama, M.; Priyangika, W.D.D.; Konradsen, F.; Eddleston, M. The Impact of Pesticide Regulations on Suicide in Sri Lanka. Int. J. Epidemiol. 2007, 36, 1235–1242. [Google Scholar] [CrossRef] [PubMed]
- Matsubayashi, T.; Ueda, M. The Effect of National Suicide Prevention Programs on Suicide Rates in 21 OECD Nations. Soc. Sci. Med. 2011, 73, 1395–1400. [Google Scholar] [CrossRef] [PubMed]
- Fountoulakis, K.N.; Gonda, X.; Rihmer, Z. Suicide Prevention Programs through Community Intervention. J. Affect. Disord. 2011, 130, 10–16. [Google Scholar] [CrossRef] [PubMed]
Characteristics | N = 1,169,593 | % |
---|---|---|
Age (in years) | ||
<10 | 252,392 | 21.6 |
10–14 | 142,121 | 12.2 |
15–17 | 62,098 | 5.3 |
18–24 | 133,534 | 11.4 |
25–64 | 508,059 | 43.4 |
65+ | 71,389 | 6.1 |
Sex | ||
Male | 567,674 | 48.5 |
Female | 601,919 | 51.5 |
Education 1 | ||
No education | 295,314 | 25.3 |
Primary complete (five years) | 407,923 | 34.9 |
Secondary complete (10 years) | 289,658 | 24.8 |
Secondary and above | 63,873 | 5.5 |
Under five children | 112,664 | 9.6 |
Occupation 2 | ||
Agriculture | 104,956 | 9.0 |
Business | 61,661 | 5.3 |
Skilled labor | 89,151 | 7.6 |
Unskilled labor | 24,520 | 2.1 |
Transport worker | 17,037 | 1.5 |
Students | 312,537 | 26.7 |
Retired/unemployed/housewife | 408,583 | 35.0 |
Children | 144,454 | 12.4 |
Others (NA) | 5948 | 0.5 |
Marital Status | ||
Married (Reference) | 571,206 | 48.8 |
Never-married | 227,319 | 19.4 |
Widowed/Divorced/Separated | 59,033 | 5.0 |
Children (<12 years) | 312,035 | 26.7 |
Wealth quintile | ||
Lowest | 211,601 | 18.1 |
Second | 218,695 | 18.7 |
Middle | 238,371 | 20.4 |
Fourth | 247,716 | 21.2 |
Highest | 253,210 | 21.6 |
Sub-district | ||
Matlab North | 265,897 | 22.7 |
Matlab South | 209,772 | 17.9 |
Chandpur Sadar | 128,356 | 11.0 |
Raiganj | 104,357 | 8.9 |
Sherpur | 228,519 | 19.5 |
Manohardi | 204,319 | 17.5 |
Daudkandi | 28,373 | 2.4 |
District | ||
Chandpur/Comilla | 632,398 | 54.1 |
Sirajganj | 104,357 | 8.9 |
Sherpur | 228,519 | 19.5 |
Narshingdi | 204,319 | 17.5 |
Characteristics | N | Fatal Suicidal Behavior | Non-Fatal Suicidal Behavior | ||||
---|---|---|---|---|---|---|---|
Person Years Observed (PYO) | Frequency | Mortality Rate per 100,000 Person Years Observed (PYO) | Person Years Observed (PYO) | Frequency | Morbidity Rate per 100,000 Person Years Observed (PYO) | ||
Total | 1,169,593 | 1,153,901 | 38 | 3.29 | 578,046 | 57 | 9.86 |
Age (in years) | |||||||
<10 | 252,392 | 240,739 | 0 | 0.00 | 122,966 | 0 | 0.00 |
10–14 | 142,121 | 141,849 | 5 | 3.52 | 70,894 | 4 | 5.64 |
15–17 | 62,098 | 61,972 | 7 | 11.30 | 30,965 | 4 | 12.92 |
18–24 | 133,534 | 133,247 | 10 | 7.50 | 66,568 | 13 | 19.53 |
25–64 | 508,059 | 506,348 | 14 | 2.76 | 252,581 | 34 | 13.46 |
65+ | 71,389 | 69,745 | 2 | 2.87 | 34,072 | 2 | 5.87 |
Sex | |||||||
Male | 567,674 | 559,566 | 20 | 3.57 | 280,538 | 28 | 9.98 |
Female | 601,919 | 594,335 | 18 | 3.03 | 297,508 | 29 | 9.75 |
Education 1 | |||||||
No education | 295,314 | 293,176 | 11 | 3.75 | 145,672 | 16 | 10.98 |
Primary complete (five years) | 407,923 | 406,727 | 9 | 2.21 | 203,011 | 17 | 8.37 |
Secondary complete (10 years) | 289,658 | 288,858 | 17 | 5.89 | 144,209 | 22 | 15.26 |
Secondary and above | 63,873 | 63,690 | 1 | 1.57 | 31,787 | 2 | 6.29 |
Under five children | 112,664 | 101,294 | 0 | 0.00 | 53,291 | 0 | 0.00 |
Occupation 2 | |||||||
Agriculture | 104,956 | 104,221 | 5 | 4.80 | 51,802 | 11 | 21.23 |
Business | 61,661 | 61,397 | 0 | 0.00 | 30,600 | 1 | 3.27 |
Skilled labor | 89,151 | 88,864 | 3 | 3.38 | 44,330 | 8 | 18.05 |
Unskilled labor | 24,520 | 24,417 | 1 | 4.10 | 12,169 | 4 | 32.87 |
Transport worker | 17,037 | 16,989 | 3 | 17.66 | 8480 | 1 | 11.79 |
Students | 312,537 | 311,935 | 12 | 3.85 | 155,892 | 6 | 3.85 |
Retired/Unemployed/Housewife | 408,583 | 406,478 | 14 | 3.44 | 202,394 | 26 | 12.85 |
Children (Under 12 years) | 144,454 | 133,003 | 0 | 0.00 | 69,125 | 0 | 0.00 |
Others (NA) | 5948 | 5857 | 0 | 0.00 | 2886 | 0 | 0.00 |
Marital Status | |||||||
Married | 571,206 | 568,601 | 25 | 4.40 | 283,292 | 37 | 13.06 |
Never-married | 227,319 | 226,802 | 11 | 4.85 | 113,320 | 15 | 13.24 |
Widowed/Divorced/Separated | 59,033 | 58,192 | 0 | 0.00 | 28,705 | 3 | 10.45 |
Children (Under 12 years) | 312,035 | 300,306 | 2 | 0.67 | 152,729 | 2 | 1.31 |
Wealth quintile | |||||||
Lowest | 211,601 | 208,601 | 7 | 3.36 | 104,479 | 10 | 9.57 |
Second | 218,695 | 215,949 | 5 | 2.32 | 108,190 | 13 | 12.02 |
Middle | 238,371 | 235,239 | 10 | 4.25 | 117,830 | 14 | 11.88 |
Fourth | 247,716 | 244,482 | 9 | 3.68 | 122,460 | 11 | 8.98 |
Highest | 253,210 | 249,630 | 7 | 2.80 | 125,088 | 9 | 7.19 |
Sub-district | |||||||
Matlab North | 265,897 | 262,510 | 7 | 2.67 | 131,406 | 11 | 8.37 |
Matlab South | 209,772 | 206,600 | 5 | 2.42 | 103,492 | 14 | 13.53 |
Chandpur Sadar | 128,356 | 126,659 | 3 | 2.37 | 63,475 | 5 | 7.88 |
Raiganj | 104,357 | 103,052 | 5 | 4.85 | 51,612 | 11 | 21.31 |
Sherpur | 228,519 | 225,476 | 6 | 2.66 | 113,055 | 4 | 3.54 |
Manohardi | 204,319 | 201,641 | 12 | 5.95 | 101,004 | 12 | 11.88 |
Daudkandi | 28,373 | 27,962 | 0 | 0.00 | 14,002 | 0 | 0.00 |
District | |||||||
Chandpur/Comilla | 632,398 | 623,732 | 15 | 2.40 | 312,375 | 30 | 9.60 |
Sirajganj | 104,357 | 103,052 | 5 | 4.85 | 51,612 | 11 | 21.31 |
Sherpur | 228,519 | 225,476 | 6 | 2.66 | 113,055 | 4 | 3.54 |
Narshingdi | 204,319 | 201,641 | 12 | 5.95 | 101,004 | 12 | 11.88 |
Age Group (Years) | Male | Female | ||||||
---|---|---|---|---|---|---|---|---|
PYO | Suicide (n) | Mortality Rate/100,000 PYO | Confidence Interval (CI) | PYO | Suicide (n) | Mortality Rate/100,000 PYO | Confidence Interval (CI) | |
<10 | 122,970 | 0 | 0.00 | 117,769 | 0 | 0.00 | ||
10–14 | 72,339 | 4 | 5.53 | 1.51–14.16 | 69,510 | 1 | 1.44 | 0.04–8.02 |
15–17 | 33,156 | 3 | 9.05 | 1.87–26.44 | 28,815 | 4 | 13.88 | 3.78–35.54 |
18–24 | 57,909 | 3 | 5.18 | 1.07–15.14 | 75,339 | 7 | 9.29 | 3.74–19.14 |
25–64 | 236,636 | 9 | 3.80 | 1.74–7.22 | 269,712 | 5 | 1.85 | 0.60–4.33 |
65+ | 36,556 | 1 | 2.74 | 0.07–15.24 | 33,189 | 1 | 3.01 | 0.08–16.79 |
Total | 559,566 | 20 | 3.57 | 2.18–5.52 | 594,335 | 18 | 3.03 | 1.79–4.79 |
Characteristics | Unadjusted | Adjusted | ||
---|---|---|---|---|
Incidence Rate Ratio (IRR) | 95% CI | Incidence Rate Ratio (IRR) | 95% CI | |
Age (in years) | ||||
15–17 | 4.09 ** | 1.64–10.12 | 6.31 * | 1.35–29.32 |
18–24 | 2.71 * | 1.2–6.11 | 4.04 * | 1.56–10.47 |
25–64 | Reference | Reference | ||
65+ | 1.04 | 0.24–4.56 | 1.48 | 0.32–6.87 |
Sex | ||||
Male | 1.05 | 0.53–2.08 | 0.87 | 0.29–2.56 |
Female | Reference | Reference | ||
Education | ||||
No education | 2.81 | 0.36–21.75 | 5.48 | 0.56–53.10 |
Primary complete (five years) | 1.50 | 0.17–12.83 | 2.27 | 0.22–22.62 |
Secondary complete (10 years) | 4.15 | 0.54–31.25 | 4.04 | 0.49–32.97 |
Secondary and above | Reference | Reference | ||
Occupation | ||||
Agriculture | 1.40 | 0.33–5.84 | 0.99 | 0.22–4.45 |
Business | 0.00 | 0.00 | ||
Skilled labor | Reference | Reference | ||
Unskilled labor | 1.25 | 0.13–12.01 | 1.20 | 0.12–11.82 |
Transport worker | 5.14 * | 1.03–25.48 | 4.25 | 0.82–21.82 |
Students | 2.89 | 0.76–10.88 | 1.86 | 0.32–10.67 |
Retired/Unemployed/Housewife | 0.95 | 0.27–3.33 | 0.62 | 0.13–2.87 |
Children (Under 12 years) | 0.00 | 0.00 | ||
Others (NA) | 0.00 | 0.00 | ||
Marital Status | ||||
Married | 0.68 | 0.31–1.47 | 3.60 | 0.92–14.06 |
Never-married | Reference | Reference | ||
Widowed/Divorced/Separated | 0.00 | 0.00 | ||
Wealth quintile | ||||
Lowest | Reference | Reference | ||
Second | 0.76 | 0.20–2.83 | 0.76 | 0.20–2.85 |
Middle | 1.55 | 0.52–4.61 | 1.71 | 0.55–5.26 |
Fourth | 1.44 | 0.48–4.28 | 1.61 | 0.51–5.07 |
Highest | 0.92 | 0.28–3.01 | 1.03 | 0.28–3.71 |
District | ||||
Chandpur/Comilla | Reference | Reference | ||
Sirajganj | 2.48 | 0.87–7.02 | 2.32 | 0.77–6.88 |
Sherpur | 1.19 | 0.41–3.37 | 0.97 | 0.33–2.89 |
Narshingdi | 2.83 * | 1.24–6.42 | 2.89 * | 1.26–6.65 |
Characteristics | Unadjusted | Adjusted | ||
---|---|---|---|---|
Incidence Rate Ratio (IRR) | 95% CI | Incidence Rate Ratio (IRR) | 95% CI | |
Age (in years) | ||||
15–17 | 0.97 | 0.34–2.72 | 1.01 | 0.25–4.03 |
18–24 | 1.46 | 0.77–2.77 | 1.31 | 0.59–2.91 |
25–64 | Reference | Reference | ||
65+ | 0.44 | 0.10–0.82 | 0.49 | 0.11–2.18 |
Sex | ||||
Male | 1.07 | 0.63–1.84 | 0.63 | 0.24–1.67 |
Female | Reference | Reference | ||
Education | ||||
No education | 1.91 | 0.44–8.35 | 1.59 | 0.31–8.02 |
Primary complete (5 years) | 2.23 | 0.51–9.75 | 1.60 | 0.45–2.00 |
Secondary complete (10 years) | 2.71 | 0.64–11.55 | 2.28 | 0.66–3.03 |
Secondary and above | Reference | |||
Occupation | ||||
Agriculture | 1.15 | 0.46–2.87 | 1.49 | 0.56–3.97 |
Business | 0.18 | 0.02–1.43 | 0.20 | 0.03–1.69 |
Skilled labor | Reference | Reference | ||
Unskilled labor | 1.87 | 0.56–6.21 | 2.25 | 0.66–7.68 |
Transport worker | 0.63 | 0.08–5.10 | 0.78 | 0.10–6.38 |
Students | 0.41 | 0.10–1.54 | 0.21 * | 0.04–1.00 |
Retired/Unemployed/Housewife | 0.69 | 0.31–1.53 | 0.57 | 0.19–1.72 |
Children (Under 12 years) | 0.00 | 0.00 | ||
Others (NA) | 0.00 | 0.00 | ||
Marital Status | ||||
Married | 0.72 | 0.39–1.37 | 0.55 | 0.22–1.38 |
Never-married | Reference | Reference | ||
Widowed/Divorced/Separated | 0.58 | 0.17–2.04 | 0.6 | 0.13–2.86 |
Children < 12 years | 0.00 | |||
Wealth quintile | ||||
Lowest | Reference | Reference | ||
Second | 1.27 | 0.53–3.00 | 1.17 | 0.49–2.80 |
Middle | 1.15 | 0.48–2.71 | 1.12 | 0.46–2.71 |
Fourth | 0.98 | 0.40–2.35 | 0.99 | 0.40–2.45 |
Highest | 0.77 | 0.30–1.94 | 0.82 | 0.30–2.19 |
District | ||||
Chandpur/Comilla | Reference | Reference | ||
Sirajganj | 2.11 * | 1.02–4.34 | 2.06 | 0.96–4.42 |
Sherpur | 0.31 | 0.09–1.01 | 0.28 * | 0.08–0.94 |
Narshingdi | 1.34 | 0.68–2.63 | 1.34 | 0.67–2.66 |
© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Sharmin Salam, S.; Alonge, O.; Islam, M.I.; Hoque, D.M.E.; Wadhwaniya, S.; Ul Baset, M.K.; Mashreky, S.R.; El Arifeen, S. The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors. Int. J. Environ. Res. Public Health 2017, 14, 1032. https://doi.org/10.3390/ijerph14091032
Sharmin Salam S, Alonge O, Islam MI, Hoque DME, Wadhwaniya S, Ul Baset MK, Mashreky SR, El Arifeen S. The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors. International Journal of Environmental Research and Public Health. 2017; 14(9):1032. https://doi.org/10.3390/ijerph14091032
Chicago/Turabian StyleSharmin Salam, Shumona, Olakunle Alonge, Md Irteja Islam, Dewan Md Emdadul Hoque, Shirin Wadhwaniya, Md Kamran Ul Baset, Saidur Rahman Mashreky, and Shams El Arifeen. 2017. "The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors" International Journal of Environmental Research and Public Health 14, no. 9: 1032. https://doi.org/10.3390/ijerph14091032
APA StyleSharmin Salam, S., Alonge, O., Islam, M. I., Hoque, D. M. E., Wadhwaniya, S., Ul Baset, M. K., Mashreky, S. R., & El Arifeen, S. (2017). The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors. International Journal of Environmental Research and Public Health, 14(9), 1032. https://doi.org/10.3390/ijerph14091032