Implementation of a comprehensive surveillance system for recording suicides and attempted suicides in rural India.
Implementation of a comprehensive surveillance system for recording suicides and attempted suicides in rural India.
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DOI：
10.1136/bmjopen-2020-038636
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发表时间：
2020-11-09
期刊：
影响因子：
2.9
通讯作者：
Shields-Zeeman L
中科院分区：
文献类型：
--
作者：
Vijayakumar L;Pathare S;Jain N;Nardodkar R;Pandit D;Krishnamoorthy S;Kalha J;Shields-Zeeman L
世卫组织报告说，140个低收入和中等收入国家中有78个没有自杀和自杀未遂登记系统。低收入和中等收入国家自杀和自杀未遂的数据不足，这是理解这一问题的严重性和制定预防战略以减少自杀和自我伤害的主要障碍。一个全面的监测系统有可能解决这一数据差距。本研究的目的是描述一个全面的监测系统在印度农村地区的发展，增加了一个社区为基础的组件，并反映其附加值在获得自杀和自杀未遂的数据相比，只依靠医院和警方的记录。该综合系统由三个部分组成。社区监测涉及从第三方关键线人，如村长、教师、牧师、店主、私人医生、私立医院和社区卫生工作者那里收集关于自杀和企图自杀的信息。第二部分是来自公共卫生设施的数据。最后一个部分包括警方记录中的自杀数据。从2018年8月到2019年7月，从印度古吉拉特邦的116个村庄（人口377276）收集了12个月的信息。每月平均采访710名社区举报人（平均：每个村庄6.72名举报人）。社区监测系统确定了67例自杀病例，与医院和警察记录的30例相比（Cochran's Q检验67.9 p<0.01），70例自杀未遂，与医院和警察记录的51例相比（Cochran's Q检验66.6 p<0.01）。这是首份在落马洲管制站实施大规模全面监察自杀及企图自杀个案系统的报告。社区监测系统与医院和警方记录的官方数据相结合，解决了印度和其他低收入国家自杀和自杀未遂报告不足的问题。
WHO reports that 78 of the 140 low-income and middle-income countries (LMICs) do not have a registration system for suicides and attempted suicides. Absence of data on suicide and attempted suicide in LMICs, which account for 79% of suicides worldwide, is a major impediment in understanding the magnitude of the problem and formulating prevention strategies to reduce suicide and self-harm. A comprehensive surveillance system has the potential to address this data gap. The objective of this study is to describe the development of a comprehensive surveillance system in rural India by adding a community based component and reflect on its added value in obtaining data on suicide and attempted suicide compared with relying only on hospital and police records. The comprehensive system consists of three components. Community surveillance involved collecting information on suicides and attempted suicides from third party key informants such as village heads, teachers, priests, shopkeepers, private physicians, private hospitals and community health workers. The second component consisted of data from public health facilities. The final component consisted of suicide data from police records. Information was collected for a period of 12 months from August 2018 to July 2019 from 116 villages (population 377 276) in Gujarat, India. An average of 710 community informants were interviewed each month (mean: 6.72 informants per village). The community surveillance system identified 67 cases of suicide compared with 30 cases by hospital and police records (Cochran’s Q test 67.9 p<0.01) and 70 attempted suicides compared with 51 from the hospital and police records (Cochran’s Q test 66.6 p<0.01). This is the first report of implementing a large-scale comprehensive surveillance system for suicide and attempted suicide in a LMIC. The combination of community surveillance system and official data from hospital and police records addresses the problem of under-reporting of suicide and suicide attempts in India and other LMIC.
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影响因子：
1.7
作者：
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通讯作者：
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影响因子：
168.9
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3.1
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64.3
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影响因子：
50
作者：
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