Suicide in rural South Africa before and during COVID-19: evidence from forensic mortuary data in Limpopo Province.

T A Malatji; K M Malatsi; M K Kitenge; U Makungo; N Arendse; M H Mphasha

doi:10.1080/17457300.2026.2698666

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Suicide in rural South Africa before and during COVID-19: evidence from forensic mortuary data in Limpopo Province.

T A Malatji·K M Malatsi·M K Kitenge·U Makungo·N Arendse·M H Mphasha

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Abstract

Suicide is a growing public health concern in South Africa, with rural provinces such as Limpopo facing heightened vulnerability due to limited mental health services and socio-economic inequalities. Evidence on the impact of COVID-19 on suicide in rural contexts remains limited. This study examined suicide trends in Limpopo Province and changes associated with the COVID-19 period. A retrospective interrupted time series analysis was conducted using forensic mortality data from 1 January 2019 to 31 December 2021, allowing assessment of pre-existing trends and changes following COVID-19 lockdowns. Among 5770 unnatural deaths, 957 were suicides. The proportion of suicides increased from 29.5% in 2019 to 36.9% in 2021. Suicides predominantly occurred among males and young adults, with hanging accounting for over 90% of deaths throughout. Interrupted time series analysis revealed a significant downward trend in suicide cases during the strict national lockdown (Alert Level 5), with a 31% reduction in incidence (IRR = 0.69, 95% CI: 0.49-0.98). Less restrictive lockdown levels showed no significant effects. Suicide mortality increased prior to COVID-19, with a subsequent decline during the strictest lockdown period. Stable demographic patterns and methods highlight persistent vulnerabilities and the need for sustained suicide-prevention strategies beyond pandemic.

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Humans South Africa COVID-19 Male Adult Suicide Rural Population Retrospective Studies Female Young Adult Middle Aged Adolescent Interrupted Time Series Analysis Aged SARS-CoV-2 forensic mortuary data interrupted time series mental health Journal Article

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T A Malatji, K M Malatsi, M K Kitenge, U Makungo, N Arendse, M H Mphasha. 2026-07-18. Suicide in rural South Africa before and during COVID-19: evidence from forensic mortuary data in Limpopo Province.. https://doi.org/10.1080/17457300.2026.2698666

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Journal Article resource Adolescent subject Adult subject Aged subject COVID-19 subject Female subject Humans subject Journal Article subject Male subject Mental Health subject Middle Aged subject

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