Patterns of homicide in Sfax, Tunisia: A 9-year cohort study (2011-2019)

In Tunisia, since the January 2011 revolution, there has been considerable media interest in violence, particularly homicides. A popular perspective is, aside from any politically motivated killings, of a rise in homicides from year to year. In the absence of Tunisian national homicide statistics, a more accurate picture may be obtainable from area pathologist records.

To examine annual homicide rates from post-mortem data for the second largest administrative area of Tunisia, Sfax, with a mixed urban-rural population of about one million people.

All victims of common law homicide for the region are taken to the forensic department of one hospital in Sfax. We conducted a retrospective and descriptive study of all such cases of homicide for the 9 year period from the date of the fall of the Tunisian government in 14 January 2011 to 31 December 2019 and linked these data to those from earlier studies in the same department.

One hundred and nine victims of unlawful homicide were identified during this nine year period, with an average of 12 cases per year and a peak of 17 cases in 2016, yielding a broadly consistent rate of 1.2 homicides per 100,000 inhabitants and no consistent pattern in fluctuations. Just over two-thirds of the victims were men. Mean age of victims was 34.85 years (range 8-90 years). Just under half were married (45%); largest employment groups were of low-paid casual workers (40%) or unemployed (28%). One third of the killings had taken place in a private residence, with interpersonal conflict given as the largest explanatory category; over one quarter were intra-familial and 14% between intimate partners. There was some seasonal variation, with nearly two-thirds of homicides occurring in the spring and summer months.

Contrary to press hype, we found no evidence of rising homicide rates in Southern Tunisia, although this does represent a different picture from that in the north of the country. The seasonal variation would merit further exploration as it raises questions around impact of fluctuations in mental health.