A case series of child suicides in Lusaka, Zambia

Suicide implies a singular motive of ending oneʼs own life by self-harm. Child suicides may be misclassified as accidental or homicidal due to a lack of history of mental illness and alteration of the scene to disguise the circumstances. This case series describes the approach to investigating suicides in children. It also described the methods used to commit suicide in children. The cases were obtained from the Office of the State Forensic Pathologistsʼ records. Cases whose manner of death was classified as suicide were selected. Coronerʼs order for postmortem forms and postmortem reports were used to obtain demographic data, history, the circumstances of death, and the methods used. Eleven children aged eight to fifteen years who committed suicide between June 2019 and September 2020 were autopsied. Of these, three were male, and eight were female. Nine hanged themselves while two ingested organophosphate compounds. To investigate child suicides adequately, the pathologist must consider the scene, history, and circumstances. The autopsy must include special dissections such as musculocutaneous dissection of the anterior, posterior torso and extremities, layered dissection of the neck and face, posterior neck dissection, and anogenital examination to reveal injuries that may have been concealed. In conclusion, correlating scene data, history, and circumstances with autopsy findings and ancillary tests are vital in opining the cause and manner of death. Every effort must be made to rule out homicide.