Suicide attempts and deaths by self-immolation: A population-based study in Fars (Iran), 2011-2019

Self-immolation is a leading public health challenge with a relatively high mortality, especially in some low- and middle-income countries. This study aimed to investigate epidemiological factors of attempts and completed suicide by self-immolation during 2011-2019 in Fars province (Iran). This retrospective cross-sectional study included 506 cases of attempted self-immolation suicide during 2011-2019 in Fars province (Iran). Demographic characteristics and suicide information were collected from the Fars Suicide Surveillance System. The first fatality rate and age-standardized mortality rates were calculated. Then, chi-square tests were performed to evaluate suicide trends and examine differences between qualitative variables and outcomes. Logistic regression was used to identify factors associated with self-immolation death. The mean age of study participants was 32.11 ± 14.04 years. The highest age-standardized rates of attempt and completed self-immolation suicide were seen in the age group 25-34 years. The fatality rate of suicide by self-immolation was 61.89%, and the risk of death was around three times higher in people with a history of suicide attempts compared to those who had no history of suicide attempts. However, a family history of suicide attempts was shown to be a protective factor against completed self-immolation suicide. The rate of self-immolation is higher in women and young adults. The results of our study can assist health policy-makers to design comprehensive plans and determine the necessary strategies aimed at identifying vulnerable people, then preventing self-immolation suicide.