ABSTRACT:
Background Suicide is a global health challenge in low- and middle-income countries(1). Global suicide rates decreased by 36% between 2000 and 2019 but the estimated decline in Africa was not as substantial(2). Globally, pesticide self-poisoning is the second most common means of suicide, however surveillance data of suicide mortality, particularly from pesticide ingestion, is lacking(3,4). This scoping review aimed to identify pesticide suicide surveillance methods currently used in African countries. Methods A scoping review was conducted across several databases in January 2022. Peer reviewed articles published in English investigating a) pesticide poisoning and b) suicide and specific to the African continent were included into the study. Four independent reviewers extracted and charted the data to ensure inter-rater reliability. Results We identified 110 studies describing 8 surveillance systems, conducted in 30 African countries. Of these studies, 50.1% (55/110) reported on the number of pesticide suicides (totaling 1,554); however, 49.0% (54/110) did not differentiate the cause of death beyond either a poisoning death or suicide, making it difficult to determine if pesticides were involved or if they were intentional poisoning case. The surveillance systems identified included health facility records (hospital admissions data), poison control center data, forensic/mortuary data (including police reports), media reports, surveys/interviews with patient/family, case reports, systematic/literature reviews, and civil registration and vital statistics data. Hospital admissions data was the most frequently used system (55.5%). Conclusions The number of studies and surveillance methods found was higher than anticipated. Several areas of improvement were identified for pesticide suicide surveillance in Africa, including improving reporting of the specific pesticides (or active ingredient) linked to suicide cases for improving policy (a requirement for pesticide regulation) and making use of more than one surveillance system to enhance surveillance coverage, allowing for underutilized sources to be used more effectively in pesticide suicide surveillance.