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SciELO Preprints
Por Guerra Vanegas JE y Pérez Martinez OJPM.
Contenido en inglés
Nicaragua has no single official source that continuously publishes suicide mortality disaggregated by sex, age, and territory.
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To describe registered suicide mortality in 2018–2025, to test its distribution by sex in 2020, to estimate departmental rates with confidence intervals, and to compare three data sources.
Ecological, observational, retrospective study using official secondary data (Ministry of Health, National Police, National Institute of Development Information, United Nations Population Division, and World Health Organization). A chi-square goodness-of-fit test (H0: parity) was applied to the 324 cases from 2020 with a recorded sex, with a sensitivity analysis for 20 cases lacking sex. Crude rates per 100,000 inhabitants were calculated with exact 95% Poisson confidence intervals (CI), together with rate ratios against the rest of the country.
Between 2018 and 2022, 330 to 426 deaths were recorded annually (401 in 2025; no comparable data for 2023–2024). National rates were 5.33 (2021) and 5.77 (2025) per 100,000. In 2020 there were 273 male and 51 female deaths (ratio 5.4:1; χ² = 152.11; p < 0.0001), a conclusion robust to the sensitivity analysis (ratio between 3.8 and 5.7). Overall, 66.3% of cases were aged 18–45 years. Madriz had the highest rate (13.73 per 100,000; 95% CI: 8.80–20.44; rate ratio versus the rest of the country 2.76; 95% CI: 1.74–4.18); Managua, with the largest absolute number, was close to the national average (5.69). The Ministry of Health and the National Police differed by 4.2% in 2020, and the WHO estimate was 27.0% and 30.0% lower than both registries, respectively.
Available records show a marked male predominance, more cases at ages 18–45, and a higher relative risk in Madriz and Matagalpa. These findings are ecological, based on crude single-year rates, and must be read alongside the discontinuity and heterogeneity of official sources.
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