A study on the incidence of suicide by hanging in the sub-region of Transkei, South Africa.

BACKGROUND Transkei is a former black homeland in South Africa. It is a historical place and well known for spearheading the freedom fight of South Africa because most of the African National Congress leaders are from this region. It was therefore deprived of development by the apartheid government and is now a poverty stricken area. Transkei is characterized by the lack of infrastructure, and hence a, high rate of unemployment. The majority of individuals are dependent on either the income of migrant mineworkers or subsistence farming at home. OBJECTIVE To estimate the incidence of suicides in the sub-region of Transkei. METHOD This is a retrospective record review of deaths due to hanging during the period of January 1993-December 2000 at the Umtata General Hospital. All medico-legal autopsies were recorded in a register at the mortuary. The names, addresses, age, and causes of deaths are found recorded in the register. The catchment areas of these autopsies are Umtata and Nqgeleni magisterial areas which have a population of about 300,000. All autopsy records were collected and analyzed manually. RESULTS There has been an increasing trend of hanging since 1993, with an overall suicidal death rate increasing from 23.7 per 100,000 in 1993 to 38.6 per 100,000 in 2000. It is observed to be higher in November 32 (13%) and least in September 12 (5%). Over half the deaths 32 (51%) due to hanging were young adults (16-30 years) and 8 (13%) adolescents less than 15 years of age. Twelve (19%) deaths were 31-45 year olds and 5 (7%) were over 61 years. CONCLUSION There is increasing incidence of deaths due to hanging in Transkei. Nearly two-thirds of them were young adults less than 30 years. RECOMMENDATION Suicidal tendency in terms of young adults is emerging as an important mental health issue that needs to be addressed. There is need of a well-planned prospective study to be carried out in Transkei.