Name: Maysa de Oliveira Silva Caliman
Type: MSc dissertation
Publication date: 17/12/2020

Namesort descending Role
Marluce Mechelli de Siqueira Advisor *

Examining board:

Namesort descending Role
Camila Alves Bahia External Examiner *
Marluce Mechelli de Siqueira Advisor *
Thiago Nascimento do Prado Internal Examiner *

Summary: Introduction: Regarded as relevant public health problem in the world, the suicide issue has drawn attention to data quality in health management. As a surveillance strategy, the National Health System (SUS) uses Information Systems (SIS) to monitor harms to health quickly and effectively. Among them, the Mortality System (SIM) and the Harm Notification Information System (SINAN) have, among other functionalities, the capacity to collect data about victims of attempted suicide and death. Objectives: To elaborate an Epidemiological Bulletin of suicide attempts and deaths in the municipality of Afonso Claudio-ES; to evaluate the completeness of form filling for the
cases of attempted suicide notified on SINAN in the period of 2014 to 2019 in Afonso Claudio/ES; to analyze the suicide mortality trend in the period of 1996 to 2018 in Brazil, in Espirito Santo State and highlands and in the municipality of Afonso Claudio/ES. Methodology: It is a descriptive and ecological study with quantitative approach, composed by secondary data attributed to attempted suicide and deaths between the years of 1996 and 2019 on SINAN and SIM. In order to analyze the data, it was used descriptive statistics, the calculation of mortality and the frequency coefficient, the Spearman’s nonparametric coefficient of linear correlation (rs) and the Prais-Winsten linear regression model. Results: An Epidemiological Bulletin – In the period of 2014 to 2019 (n) 32 deaths by suicide were registered on SIM and (n) 268 cases of attempted suicide were registered on SINAN, of which, (n) 213 cases were registered on the Exogenous Intoxication forms and (n) 55 cases on the self-generated
interpersonal harm form. On SINAM, the majority of attempted suicide occurred in the individual’s own residence. Most of the cases of attempted suicide registered in the interpersonal self-generated harm form were in the female gender, while most of the cases registered in the exogenous intoxication notification instrument were in the male gender. On SIM, suicide cases occurred in a larger number of grayish-brown and married men, and the main kind of aggression was hanging followed by selfintoxication. Scientific article 1- Concerning the completeness of form filling of attempted suicide notifications, it was verified (n) 268 cases. It was found as “good” to “excellent” the quality of the variable analyzed on the exogenous intoxication instrument. And as “poor” to “good” the variables on the interpersonal or self-generated
harm form. Trends to non-completeness were increasing and statistically significant only for the variables “having any kind of disability/disorder”, “happened previously” and “referral” on the interpersonal and self-generated harm notification form. Scientific article 2- The analyzes of suicide mortality coefficients enabled to point that the municipality of Afonso Claudio has larger suicide rates than the other municipalities in the highlands of Espirito Santo State and the country, with a steady trend in the observed period. The standardized rate of suicide mortality revealed an increasing trend in the general population in Brazil to both genders (APC: 0.69; p-rate: 0.000). An
increasing trend also among women in Espirito Santo State (APC: 1.85; p-rate: 0.020) and RS (APC: 4.23; p-rate: 0.030). From 15 to 29 years old in Brazil, the trend was increasing for both genders (APC: 0.69; p-rate: 0.000), from 30 to 59 years old, the trend was increasing in Brazil (APC: 0.46; p-rate: 0.000) and in ES State (APC: 2.09; p-rate: 0.000), and in the ages under 60 years old, it was steady in all units analyzed.
Product: It was developed an Epidemiological Bulletin of attempted suicide and
deaths in the municipality of Afonso Claudio/ES and two scientific articles.
Conclusion: This research can potentially generate impact locally, statewide,
regionally and nationally. This study resulted in the elaboration of an epidemiological bulletin, through notified cases and records of attempted suicide and deaths, an important tool for the process of health planning. The analysis of non-completeness of SINAN notification instruments enabled to identify the variables that need refinement in form filling, fostering improvement of the epidemiological monitoring of this harm, and promoting to better direct individuals to mental health services. Findings of the trend analysis on suicide mortality showed the need of plan and implementation of
prevention-oriented actions against suicide behavior, and health promotion, meeting the needs of risk groups and vulnerable individuals in all analyzed units.

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