Research Homicide in children and adolescents: a case– control study in Recife, Brazil

Objective The homicide rate for children and adolescents in Recife, Brazil, mostly caused by firearms, is one of the highest that has been reported. The present case–control study was designed to identify factors that were potentially modifiable through preventive interventions. Methods Cases were 255 homicide victims under 20 years of age, who had died in 1997 and been identified at the Institute of Forensic Medicine, Police Department, Recife, and whose relatives were interviewed by two community health workers when they claimed the corpse. The 255 controls were neighbours of the cases, paired by age and sex to them, and identified within one week of identification of each case, and whose relatives were interviewed by a third community health worker. Findings The overall homicide rate in Recife for under-20-year-olds in 1997 was 49 per 100 000; among males aged 15–19 years it was 324 per 100 000. Firearms were responsible for 97% of deaths. After multivariate logistic regression, history of personal police records (odds ratio (OR) = 18.65; 95% confidence interval (CI) = 1.91– 182.50), use of illicit drugs (OR = 7.48; 95% CI = 1.86–30.17), tap water at home (OR = 7.30; 95% CI = 1.80– 29.59), and maternal age at birth over 26 years (OR = 3.98; 95% CI = 1.79–8.84) were identified as risk factors, while higher education (OR = 0.22; 95% CI = 0.11–0.43), religious practice (OR = 0.25; 95% CI = 0.10–0.65), and presence of the father in the household (OR = 0.28; 95% CI = 0.09–0.81) were protective factors. Conclusion Public health authorities should plan preventive interventions based on the findings of this study and should control the acquisition, possession and carrying of firearms.