title: Suicide Attempts and Deaths in Sofala, Mozambique, From 2011 to 2014.
abstract: BACKGROUND
  Mozambique was recently estimated to have the highest suicide rate in Africa.
  
  
  OBJECTIVE
  To fill a knowledge gap on suicide attempts and deaths in Mozambique.
  
  
  METHODS
  We reviewed a census of 898 emergency psychiatric consultations from March 2013 to July 2014 and 1,173 violent death autopsy records from June 2011 to August 2014 at Beira Central Hospital in Sofala, Mozambique.
  
  
  RESULTS
  In all, 18.0% of emergency psychiatric consultations were suicide attempts. Females were disproportionately represented (68.3%, p < .001), and the mean age was 26.8 years. Rat poison was used in 66% of attempts, followed by unspecified methods (19.8%), and unspecified poisoning (6.8%). Of the violent death autopsies, 10% were suicides. Suicide deaths were more likely to be male (67.3%, p < .001), and the mean age was 30.8 years. Common methods were hanging (43.2%), unspecified substance (28.0%), or rat poison (26.3%). Common places of death were the hospital or hospital transit (46.4%) and the household (35.7%). Female suicide deaths more often involved toxic substances and males more often employed hanging.
  
  
  CONCLUSIONS
  Females more often present with suicide attempts, but deaths due to suicide are more frequent among males. Females more often use toxic substances, whereas males more often use lethal methods, such as hanging. Policies to reduce the availability or toxicity of rat poison should be considered.
authors.affiliation: 1 Department of Global Health, University of Washington, Seattle, WA, USA.|2 Health Alliance International, Seattle, WA, USA.
authors.forename: Bradley H
authors.initials: BH
authors.lastname: Wagenaar
authors.affiliation: 1 Department of Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Manuela
authors.initials: M
authors.lastname: Raunig-Berhó
authors.affiliation: 3 Sofala Provincial Health Directorate, Department of Mental Health, Ministry of Health, Beira, Mozambique.|4 Beira Central Hospital, Department of Medicine, Psychiatric Services, Beira, Mozambique.
authors.forename: Vasco
authors.initials: V
authors.lastname: Cumbe
authors.affiliation: 1 Department of Global Health, University of Washington, Seattle, WA, USA.|5 Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Rao
authors.affiliation: 6 Beira Operations Research Center, Ministry of Health, Beira, Mozambique.
authors.forename: Manuel
authors.initials: M
authors.lastname: Napúa
authors.affiliation: 1 Department of Global Health, University of Washington, Seattle, WA, USA.|2 Health Alliance International, Seattle, WA, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Sherr
mesh_terms: D000293:Adolescent; D000328:Adult; D001237:Asphyxia / Q000453:epidemiology*; D001344:Autopsy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D011041:Poisoning / Q000453:epidemiology*; D013405:Suicide / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Mozambique; epidemiology; mental health systems; methods of suicide; suicide attempts