Abstract
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.