Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps

Purpose:
To assess the prevalence of suicidality and associated factors of suicide risk in a sample of Burundian refugee families living in three refugee camps in Tanzania.

Methods:
Children (n = 230) and their parents (n = 460) were randomly selected and interviewed about suicidality (suicidal ideation, plans, and attempts) and a range of sociodemographic, psychological, and environmental factors. Multinomial logistic regression analyses were conducted to examine factors associated with children and parents’ lower and moderate or high current suicide risk.

Results:
Past-month prevalence of suicidal ideation, plans, and attempts were 11.3%, 0.9% and 0.9%, respectively, among children; 37.4%, 7.4% and 5.2%, respectively, among mothers; and 29.6%, 4.8% and 1.7%, respectively, among fathers. Older age in years (aORlower = 2.20, 95% CI 1.38–3.51; aORmoderate/high = 3.03, 95% CI 1.15–7.99) and higher levels of posttraumatic stress disorder symptoms (aORlower = 1.64, 95% CI 1.05–2.57; aORmoderate/high = 2.30, 95% CI: 1.02–5.16), internalizing (aORmoderate/high = 2.88, 95% CI 1.33–6.26) and externalizing problems (aORlower = 1.56, 95% CI: 1.06–2.31; aORmoderate/high = 3.03, 95% CI 1.42–6.49) were significantly positively associated with children’s current suicide risk. For mothers, higher perceived instrumental social support (aORmoderate/high = 0.05, 95% CI < 0.01–0.58) was significantly negatively related to suicide risk, whereas exposure to community violence (aORlower = 1.97, 95% CI 1.30–2.99; aORmoderate/high = 1.59, 95% CI 1.00–2.52), living in larger households (aORlower = 1.74, 95% CI 1.17–2.57), and higher psychological distress (aORmoderate/high = 1.67, 95% CI 1.05–2.67) were significantly positively associated with suicide risk. For fathers, higher perceived instrumental social support (aORmoderate/high = 0.04, 95% CI < 0.01–0.44) and having more years of formal education (aORmoderate/high = 0.58, 95% CI 0.34–0.98) were significantly negatively and exposure to war-related trauma (aORmoderate/high = 1.81, 95% CI 1.03–3.19) was significantly positively associated with suicide risk.

Conclusion:
Prevention programs should target psychopathology, community violence and social support to mitigate children and parents’ current suicide risk.