Mortality in Paraguayan adolescents: retrospective study (2018-2022)
Keywords:
Adolescent mortality, Traffic accidents, suicideAbstract
Introduction: Adolescence carries health risks with long-term consequences. In Paraguay, suicide, road traffic injuries, and complications of adolescent pregnancy are among the leading causes of death, with regional inequalities and limited knowledge of these patterns. Objective: To describe the causes and trends of mortality in Paraguayan adolescents from 2018-2022, analyzing differences by age, sex, and region. Methodology: Observational, descriptive, cross-sectional, population-based study. Official death records of adolescents aged 10 to 18 years (2018-2022) from the General Directorate of Strategic Health Information were analyzed. Variables were cause of death (ICD-10), age, and sex. Rates were calculated by year, age, sex, and cause, and trends were assessed using linear regression. Results: A total of 2,766 deaths were recorded (rate: 44.87 per 100,000; 95% CI: 43.21-46.57). Leading causes were road traffic injuries (n=605; 9.81), suicide (n=446; 7.23), and infectious causes (n=384; 6.23), 51.9% of the total. Rates were higher in males and at 15-18 years. No temporal trend was significant (p>0.05). Road traffic injuries were highest in the Southern region and suicide in the Chaco. Conclusion: Adolescent mortality in Paraguay shows persistent patterns of premature death from external injuries, mental health problems, and infections, with differences by sex and region. Comprehensive policies are needed on road safety, suicide prevention, mental health, sexual and reproductive health, and health services, especially in the most affected regions.
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1. Chaku N, Davis-Kean PE. Positioning adolescence in the developmental timeline. J Res Adolesc. 2024;34(4):1191-1200. https://doi.org/10.1111/jora.12928
2. The Psychodynamic Formulation Collective. Psychodynamic formulation: an expanded approach. Hoboken (NJ): Wiley; 2022. https://doi.org/10.1002/9781119909804
3. Stemmann A. Topographies of adolescence. In: Spaces of adolescence: contemporary German-language youth literature in topographical perspective. Stuttgart: Palgrave Macmillan; 2023. p. 1-17. https://doi.org/10.1007/978-3-476-05916-1_1
4. Roșu CA. Adolescența – o vârstă între vârste. In: Scheau I, Opriş D, Negru M, editors. Educaţie şi valori în şcoala contemporană. Provocări şi modele. Cluj-Napoca: Editura Eikon; 2023. p. 91-97. https://www.ceeol.com/search/chapter-detail?id=1201512
5. Greš A, Staver D, Šakić B, Radovančević LJ. Risky behaviour among adolescents. Scr Med. 2023;54(2):201-206. https://doi.org/10.5937/scriptamed54-43365
6. Bulycheva EV. Adolescents' relationships with the social environment as a factor of protection against risky behaviours. Natl Psychol J. 2023;49(1):88-101. https://doi.org/10.11621/npj.2023.0108
7. Dong Y, Hu P, Song Y, Dong B, Zou Z, Wang Z, et al. National and subnational trends in mortality and causes of death in Chinese children and adolescents aged 5-19 years from 1953 to 2016. J Adolesc Health. 2020;67(5S):S3-S13. https://doi.org/10.1016/j.jadohealth.2020.05.012
8. Strong KL, Pedersen J, White Johansson E, Cao B, Diaz T, Guthold R, et al. Patterns and trends in causes of child and adolescent mortality 2000-2016: setting the scene for child health redesign. BMJ Glob Health. 2021;6(3):e004760. https://doi.org/10.1136/bmjgh-2020-004760
9. Uzunov AV, Meca DC, Cîrstoiu MM. Mortalitatea maternă şi fetală în rândul pacientelor adolescente. Ginecologia.ro. 2022;4(38):22. https://doi.org/10.26416/Gine.38.4.2022.7387
10. Castellano Torres E, Morel Burgos L. Las desigualdades en la niñez y adolescencia de Paraguay: un monitoreo para no dejar a nadie atrás. Asunción: Coordinadora por los Derechos de la Infancia y la Adolescencia (CDIA); 2021. 138 p. https://www.cdiaobserva.org.py/wp-content/uploads/2024/03/Informe-Desigualdades-11marzo2024-1.pdf
11. Torales J, Barrios I, Tullo-Gómez JE, Melgarejo O, Gómez N, Riego V, et al. Suicides among children and adolescents in Paraguay: an 18-year national exploratory study (2004-2022). Int J Soc Psychiatry. 2023;69(7):1649-1657. https://doi.org/10.1177/00207640231169656
12. Taniguchi H, Shaikh MA. Prevalence and correlates of physical fighting among adolescents in Paraguay: findings from the 2017 national school-based health survey. PLoS One. 2022;17(12):e0279402. https://doi.org/10.1371/journal.pone.0279402
13. Aguilar G, Miranda AE, Rutherford GW, Muñoz S, Hills N, Samudio T, et al. Mortality rate and predictors in children under 15 years old who acquired HIV from mother to child transmission in Paraguay. AIDS Behav. 2018;22(Suppl 1):99-104. https://doi.org/10.1007/s10461-018-2053-1
14. United Nations Population Fund. 2020 orange book of results – volume 3: key results achieved at the country level. New York: United Nations; 2023. https://doi.org/10.18356/9789210057738
15. Tunesi S, Tambuzzi S, Decarli A, Cattaneo C, Russo AG. Trends in mortality from non-natural causes in children and adolescents (0-19 years) in Europe from 2000 to 2018. BMC Public Health. 2023;23(1):2223. https://doi.org/10.1186/s12889-023-17040-5
16. Zavala M. Factores psicosociales intervinientes en el intento de suicidio de adolescentes paraguayos. Rev Cient Arbitr Fund MenteClara. 2022;7:283. https://fundacionmenteclara.org.ar/revista/index.php/RCA/article/view/283
17. Bjorkman C, Rice T. Adolescent suicidality and homicidality: who is at risk? In: Dodson NA, editor. Adolescent gun violence prevention: clinical and public health solutions. Cham: Springer; 2021. p. 101-111. https://doi.org/10.1007/978-3-030-84710-4_8
18. Neal S, Mahendra S, Bose K, Camacho AV, Mathai M, Nove A, et al. The causes of maternal mortality in adolescents in low and middle income countries: a systematic review of the literature. BMC Pregnancy Childbirth. 2016;16(1):352. https://doi.org/10.1186/s12884-016-1120-8
19. Liu L, Villavicencio F, Yeung D, Perin J, Lopez G, Strong KL, et al. National, regional, and global causes of mortality in 5-19-year-olds from 2000 to 2019: a systematic analysis. Lancet Glob Health. 2022;10(3):e337-e347. https://doi.org/10.1016/S2214-109X(21)00566-0
20. World Health Organization. Global health estimates. Geneva: WHO; 2024. https://www.who.int/data/global-health-estimates
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Copyright (c) 2026 Carlos Miguel Rios-González, Miriam Espínola-Canata, Marta Ferreira-Gaona, Julieta María Méndez-Romero, Juan Edgar Tullo-Gómez, Gladys Mercedes Estigarribia-Sanabria, Ana Carolina Aguilar-Rabito, Silvia Stella Araújo Pino, Gloria Celeste Aguilar-Barreto
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