This study was conducted to determine the prevalence of suicidal ideation and associated factors among Eritrean college students. Variables such as gender, age, , religious activity, Anxiety, depression and alcohol abuse, etc. –will have some influence whether we are aware of it or not . For example the study performed by Kirkpatrick-Smith et al. (1991) attempted to test the predictiveness of life stresses, hopelessness, and reasons for living, loneliness, depression, and alcohol abuse on suicide. 
This study was conducted on 466 college students consisting 88.9% from the Tigrinya ethnic group. The participants were from all the regions and majority was from the central region (80%). There were 236 male and 224 female respondent s. The age of the respondents ranged from 18 to 36, with the highest ranged 18 to 23 (95.5%). About Sixty four percent 64.1% of the participants were degree program and most (90.2%) of the participants were Christian. Ninety five percent of the respondents attended religious activity. 68.7% of the students lived with both of their parents and 55.8% of the participants lived in the school dormitory.
Forty three percent of the participants had had substance use; 37.4% had only alcohol consumption, 0. 9% had only smoked cigarette, 0.4% had tobacco use and 2.4% had used alcohol and cigarette. , this can be due to high levels of stress associated with adjusting to a new social environment and increased academic demands.
By studying the effects of these variables, we can start comparing results and start understanding which factors may influence people to have suicidal ideations more than others. The results of this study also show that 29% of males and 23% of females have suicidal ideation but no significant differences were observed in suicide ideation. The factors that had a significant association to suicidal ideation were Anxiety; Depression, Alcohol abuse, attending religious activity, satisfaction with the credit hours assigned, and perceived social support (FAM, FRI and SO). Among these factors, depression had the highest prevalence across all colleges (in all the students who had ideation and not). On the other hand variables such as where do you live, sex , study program, type of religion were not significantly associated with suicidal ideation.
In our study the prevalence of suicidal ideation was 25.9%, this high prevalence could be due the high prevalence of the predicting factors among those students with suicidal ideation. A study conducted in Ethiopia had a prevalence of 19.9%. However, this finding was low compared with results of similar studies in other African countries. For example, it was much lower than the prevalence of suicidal ideation reported among Botswana students (47.5%). Similarly, higher prevalence suicidal ideation has been reported among South African medical students (32.3%). Despite of the above findings the prevalence of 10.7% was reported for university student in China and Portugal [24, 25].
Colleges of education have the highest (35.5%) prevalence of suicidal ideation followed by college of engineering and college of science with prevalence of 33.8% and 31.2% respectively. This was mainly due to higher prevalence of the predicting variables and lower preventive factor when compared to the other colleges. Even though the prevalence of suicidal ideation in colleges of marine (29.2%) and agriculture (20%) was lower than these colleges, it was still unacceptably high and this might be due to the high prevalence of anxiety , depression , setting of the colleges and their geographical location.
In our study males had higher (29%) prevalence of suicide ideation than females (23%) but it was not found to be statistically significant. A study conducted in Ethiopia in January 2018 reported the prevalence of females (21.5%) was not significantly different to that of males (19%) .This is, probably, mainly due to low or no prejudice/stigma between female and male. A Similar study conducted in south Africa reported that 16% of males had suicidal ideations and the difference between male and female students were not significant  While study conducted by public health students among adult Students in four countries (Jordan, Lebanon, Morocco and UAE) reported that all of the countries, with the exception of the UAE, reported a higher prevalence of suicide ideation among female than males. But the difference between male and female students were significant with regard to differences in occurrences in suicide ideation, In Lebanon, males were 0.75 times less likely than females to have thoughts of suicide, and males in Morocco were 0.6 times less likely than females to have thoughts of suicide. A study done in Uganda revealed that the prevalence of suicide ideation in males was 17.2% and in females was 22.1%. Gender was only found to be significantly associated with suicidal ideation . These significant differences might be due to culture.
The present study revealed that higher suicidal ideation was found among students with age range 18-23 (95.8%) and based on regression analysis as age increases by one year the risk of suicidal ideation is 1.127 times more. This might be due to the fact that during the age period 18-24 years of age severe psychiatric disorders typically manifest themselves and disrupt a student.  Similarly a study conducted among U.S medical students reveled that higher suicidal ideation was found among students with age range 25-30 (12.7%) and they were 1.62 times higher to have suicidal ideation as compared to the lower age . However, a study conducted in Ethiopia showed that there were no significant association between age and suicidal ideation .
In this study the most frequently recognized risk factor was alcohol abuse (62%) followed by depression (42.6%) and anxiety (41.5%). While in a study conducted by Hamline University, the most frequently recognized risk factor was anxiety 61.9%, followed by depression (60.6%), alcohol and drug abuse (58.2%) . A study conducted across sub-Saharan countries (Kenya, Tanzania, Uganda) the most frequent recognized risk factor was sadness, followed by feeling lonely .
Suicidal ideation increases with increasing severity of depression. As seen in this study among mildly depressed, moderately depressed and severely depressed groups the suicidal ideation was 25.4%, 37.5% and 63.9% respectively (AOR=1.913 CI=1.151 - 3.18), this might be due to high levels of stress associated with adjusting to a new social environment, increased academic demands and could be due to the effect of high dose of alcohol consumption. Similarly a study conducted in India showed that suicidal ideation increases with the severity of depression. Among mildly, moderately, severely and extremely depressed groups the suicidal ideation was 23.1%, 40.6%, 68.35%, and 84.2% respectively
This study revealed that from the respondents 5.2% and 5.7% were placed under harmful alcohol use and alcohol dependent respectively whereas a study reported by Dorian A. Lamis in Sri Lanka, 19.3% and 9.3% were placed under harmful alcohol use and alcohol dependent respectively and in both the studies alcohol was significantly associated with suicidal ideation. This high dependency rate could be due to absence of strong disciplinary measures.
In this study alcohol abuse was significantly associated with suicidal ideation. Students who abuse alcohol were 3.394 times more at risk to have suicidal ideation than those who did not (AOR=3.394 CI=1.684-6.843)
Similarly, a study conducted in Ethiopia found that alcohol abuse was significantly associated with suicidal ideation with AOR 1.6 . Likewise Students who consumed alcohol in Morocco had a higher associated risk of suicide ideation 2.31 times more likely to have thoughts of suicide than students who did not consume alcohol) than students who consumed alcohol in Lebanon (1.43 times more likely) .
Anxiety was significantly associated with suicidal ideation in this study. About 42% of the respondents who were anxious have suicidal ideation (AOR1.786 CI 1.06-2.987, X2=23.156, p=0.001). This could be due to the fact that school time is one of the influential times in the individuals’ future life so they might get frustrated in order to line up their futures in a good way; this might make them feel anxious. Similarly a study conducted at Emory university reported anxiety was significantly associated with suicidal ideation, from the total respondents who have suicidal ideation 92.6% were anxious(x2=15.2).
In this study the mean value of the subscales of MSPSS of family, friend and significant other was 21.66, 21.19 and 20.42 respectively. This means they perceive support mainly from family. The regression analysis revealed that subscale family and significant other were significant predictors for suicidal ideation (AOR=0.939 CI 0.891-0.990) and AOR=0.95 CI 0.90-0.996) but not for subscale friend (AOR=1.02 CI 0.972-1.08)).The social relationships with family can act as a buffer towards suicidal behaviors. This is because these students (those who perceive social support from their family) do feel an obligation to stay alive for of their family. While other study conducted in India reported that the mean value of the subscales of MSPSS of family, friend and significant other was 23.99, 21.12, and 21.38 respectively this means they perceive support mainly from family. And based on regression analysis they found that subscale family was a significant predictor for suicidal ideation (AOR =0.369) while not for subscales friend and significant other . However a study conducted by Lamis and Lester found that study participants were found to have decreased suicidal thoughts with healthy peer relationships .
In general social support increases a feeling of belongingness and thus reduces the risk of suicidal thought 
In this study religious activity was significantly associated with suicidal ideation (respondents who attend religious activities were 0.258 times less likely to have suicidal ideation than respondents who never attend to religious activities.) This might be due to the religious lessons that act as a preventive means from suicidal behaviors. Also various studies have showed that people who report being more religious also report lower levels of suicide ideation, and people who report being less religious also report greater suicide ideation . However, a study conducted in Ethiopia showed that religious activity was not significantly associated with suicidal ideation (AOR =1.54 CI 0.89–2.67))