标题：Comparison of the Clusters and Non-Clusters Areas of Attempted Suicide Cases in Hamadan Province, Western Iran: Findings from a Pilot Study (2016-2017)
摘要：Background: Suicide behaviors are complex and multifactorial problems that in the most of the societies are considered as the public health challenge. However, its underlying reasons and spatial pattern remain unclear in Hamadan Province, western Iran. Study design : Secondary analysis of existing data. Methods: We assessed the spatial pattern pre-city regarding some influencing factors by scan-statistics and logistic regression to detect clusters areas and its comparison with other areas for the period of 2016-2017. All of the registered cases of attempted suicide in a quality registry system of suicide in Sina (Farshchian) Hospital affiliated to Hamadan University of Medical Sciences, Hamadan, Iran were enrolled. Results: Two significant clusters were detected in study areas, formed with relative risk at 5.28 ( P =0.001) and 6.33 ( P =0.017), and with the centrality of Asadabad and Razan, respectively. Clusters and non-clusters areas were differed in terms of location (OR=0.15, 95%, CI: 0.07, 0.31), self-harms methods (OR=0.28, 95%, CI: 0.9, 0.88) and education. Residents of rural areas, illiterate people and non-drug user cases have more likely to be in a cluster. Conclusions: Clusters were not formed equally among cities of Hamadan Province. Accordingly, we suggest the implementation of appropriate, long-term and evidence-based educations for high-risk and vulnerable groups through the intersectoral interventions in different parts of Hamadan Province (considering the cluster and non-clusters areas) to avert deaths and related injuries from attempted suicide.
其他摘要：Background: Suicide behaviors are complex and multifactorial problems that in the most of the societies are considered as the public health challenge. However, its underlying reasons and spatial pattern remain unclear in Hamadan Province, western Iran. Study design : Secondary analysis of existing data. Methods: We assessed the spatial pattern pre-city regarding some influencing factors by scan-statistics and logistic regression to detect clusters areas and its comparison with other areas for the period of 2016-2017. All of the registered cases of attempted suicide in a quality registry system of suicide in Sina (Farshchian) Hospital affiliated to Hamadan University of Medical Sciences, Hamadan, Iran were enrolled. Results: Two significant clusters were detected in study areas, formed with relative risk at 5.28 ( P =0.001) and 6.33 ( P =0.017), and with the centrality of Asadabad and Razan, respectively. Clusters and non-clusters areas were differed in terms of location (OR=0.15, 95%, CI: 0.07, 0.31), self-harms methods (OR=0.28, 95%, CI: 0.9, 0.88) and education. Residents of rural areas, illiterate people and non-drug user cases have more likely to be in a cluster. Conclusions: Clusters were not formed equally among cities of Hamadan Province. Accordingly, we suggest the implementation of appropriate, long-term and evidence-based educations for high-risk and vulnerable groups through the intersectoral interventions in different parts of Hamadan Province (considering the cluster and non-clusters areas) to avert deaths and related injuries from attempted suicide.
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