Self-poisoning in rural Sri Lanka: small-area variations in incidence

<p>Abstract</p> <p>Background</p> <p>Self-poisoning is one of the most common methods of suicide worldwide. The intentional ingestion of pesticides is the main contributor to such deaths and in many parts of rural Asia pesticide self-poisoning is a major public health p...

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Main Authors: Dawson Andrew, van der Hoek Wim, Gunnell David J, Manuel Celie, Wijeratne Ishika K, Konradsen Flemming
Format: Article
Language:English
Published: BMC 2008-01-01
Series:BMC Public Health
Online Access:http://www.biomedcentral.com/1471-2458/8/26
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author Dawson Andrew
van der Hoek Wim
Gunnell David J
Manuel Celie
Wijeratne Ishika K
Konradsen Flemming
author_facet Dawson Andrew
van der Hoek Wim
Gunnell David J
Manuel Celie
Wijeratne Ishika K
Konradsen Flemming
author_sort Dawson Andrew
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Self-poisoning is one of the most common methods of suicide worldwide. The intentional ingestion of pesticides is the main contributor to such deaths and in many parts of rural Asia pesticide self-poisoning is a major public health problem. To inform the development of preventive measures in these settings, this study investigates small-area variation in self-poisoning incidence and its association with area-based socioeconomic and agricultural factors.</p> <p>Methods</p> <p>Ecological analysis of intentional self-poisoning in a rural area (population 267,613) of Sri Lanka in 2002. The geographic distribution of cases was mapped to place of residence. Using administrative division (GN), median population size 1416, as unit of analysis, associations with socioeconomic and agricultural indicators were explored using negative binomial regression models.</p> <p>Results</p> <p>The overall incidence of intentional self-poisoning in the study area was 315 per 100,000 (range: 0 – 2168 per 100,000 across GNs). Socioeconomic disadvantage, as indexed by poor housing quality (p = 0.003) and low levels of education (p < 0.001) but not unemployment (p = 0.147), was associated with a low self-poisoning incidence. Areas where a high proportion of the population worked in agriculture had low overall levels of self-poisoning (p = 0.002), but a greater proportion of episodes in these areas involved pesticides (p = 0.01). An association with extent of cultivated land was found only for non-pesticide poisoning (p = 0.01).</p> <p>Conclusion</p> <p>Considerable small-area variation in incidence rates of intentional self-poisoning was found. The noteworthy concentration of cases in certain areas and the inverse association with socioeconomic deprivation merit attention and should be investigated using individual-level exposure data.</p>
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spelling doaj.art-5083320d580f44c9a3f1815b9f31ae5f2022-12-21T22:00:45ZengBMCBMC Public Health1471-24582008-01-01812610.1186/1471-2458-8-26Self-poisoning in rural Sri Lanka: small-area variations in incidenceDawson Andrewvan der Hoek WimGunnell David JManuel CelieWijeratne Ishika KKonradsen Flemming<p>Abstract</p> <p>Background</p> <p>Self-poisoning is one of the most common methods of suicide worldwide. The intentional ingestion of pesticides is the main contributor to such deaths and in many parts of rural Asia pesticide self-poisoning is a major public health problem. To inform the development of preventive measures in these settings, this study investigates small-area variation in self-poisoning incidence and its association with area-based socioeconomic and agricultural factors.</p> <p>Methods</p> <p>Ecological analysis of intentional self-poisoning in a rural area (population 267,613) of Sri Lanka in 2002. The geographic distribution of cases was mapped to place of residence. Using administrative division (GN), median population size 1416, as unit of analysis, associations with socioeconomic and agricultural indicators were explored using negative binomial regression models.</p> <p>Results</p> <p>The overall incidence of intentional self-poisoning in the study area was 315 per 100,000 (range: 0 – 2168 per 100,000 across GNs). Socioeconomic disadvantage, as indexed by poor housing quality (p = 0.003) and low levels of education (p < 0.001) but not unemployment (p = 0.147), was associated with a low self-poisoning incidence. Areas where a high proportion of the population worked in agriculture had low overall levels of self-poisoning (p = 0.002), but a greater proportion of episodes in these areas involved pesticides (p = 0.01). An association with extent of cultivated land was found only for non-pesticide poisoning (p = 0.01).</p> <p>Conclusion</p> <p>Considerable small-area variation in incidence rates of intentional self-poisoning was found. The noteworthy concentration of cases in certain areas and the inverse association with socioeconomic deprivation merit attention and should be investigated using individual-level exposure data.</p>http://www.biomedcentral.com/1471-2458/8/26
spellingShingle Dawson Andrew
van der Hoek Wim
Gunnell David J
Manuel Celie
Wijeratne Ishika K
Konradsen Flemming
Self-poisoning in rural Sri Lanka: small-area variations in incidence
BMC Public Health
title Self-poisoning in rural Sri Lanka: small-area variations in incidence
title_full Self-poisoning in rural Sri Lanka: small-area variations in incidence
title_fullStr Self-poisoning in rural Sri Lanka: small-area variations in incidence
title_full_unstemmed Self-poisoning in rural Sri Lanka: small-area variations in incidence
title_short Self-poisoning in rural Sri Lanka: small-area variations in incidence
title_sort self poisoning in rural sri lanka small area variations in incidence
url http://www.biomedcentral.com/1471-2458/8/26
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AT manuelcelie selfpoisoninginruralsrilankasmallareavariationsinincidence
AT wijeratneishikak selfpoisoninginruralsrilankasmallareavariationsinincidence
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