From pesticides to medicinal drugs: time series analyses of methods of self-harm in Sri Lanka
From pesticides to medicinal drugs: time series analyses of methods of self-harm in Sri Lanka
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DOI：
10.2471/blt.11.091785
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
Hanwella, R
中科院分区：
文献类型：
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作者：
Silva, Varuni A de;Senanayake, SM;Hanwella, R
目的探讨在斯里兰卡的自我伤害的方法最近的变化可以解释自杀率下降的发病率。方法自杀率和住院治疗，由于不同类型的中毒进行了时间序列分析。结果在1996年和2008年之间，每年的发病率住院治疗由药物或生物物质中毒呈指数增长，从每10万人48.2人增加到115.4人。同期，每年因农药中毒而入院的人数由每10万人105.1人下降至88.9人。每年的自杀发生率呈指数下降，从1995年的每10万人47.0人的峰值下降到2009年的每10万人19.6人。1995年，每10万人中有37.4人自杀，但2009年每10万人中只有11.2人自杀。农药中毒病死率呈直线下降趋势，从1997年的11.0/100例下降到2008年的5.1/100例。从滥用杀虫剂（尽管农药供应量没有减少）在斯里兰卡，寻求自残的人中有越来越多的人使用医药和其他物质。这些趋势和农药中毒死亡率的降低导致全国自杀未遂发生率的总体下降。
Objective To explore if recent changes in methods of self-harm in Sri Lanka could explain the decline in the incidence of suicide.Methods Time series analyses of suicide rates and hospitalization due to different types of poisoning were carried out.Findings Between 1996 and 2008 the annual incidence of hospital admission resulting from poisoning by medicinal or biological substances increased exponentially, from 48.2 to 115.4 admissions per 100 000 population. Over the same period, annual admissions resulting from poisoning with pesticides decreased from 105.1 to 88.9 per 100000. The annual incidence of suicide decreased exponentially, from a peak of 47.0 per 100 000 in 1995 to 19.6 per 100 000 in 2009. Poisoning accounted for 37.4 suicides per 100 000 population in 1995 but only 11.2 suicides per 100 000 in 2009. The case fatality rate for pesticide poisoning decreased linearly, from 11.0 deaths per 100 cases admitted to hospital in 1997 to 5.1 per 100 in 2008.Conclusion Since the mid 1990s, a trend away from the misuse of pesticides (despite no reduction in pesticide availability) and towards increased use of medicinal and other substances has been seen in Sri Lanka among those seeking self-harm. These trends and a reduction in mortality among those suffering pesticide poisoning have resulted in an overall reduction in the national incidence of accomplished suicide.