Injury and social determinants among in-school adolescents in six African countries

Objectives: To determine estimates of the prevalence of injury among adolescents in six African countries, and to examine the consistency of associations cross nationally between sociodemographics, social risk factors and the occurrence of adolescent injury in Africa.
There is in particular lack of data regarding injury and its social correlates among in-school adolescents in Africa.
Design: Cross-sectional national data from the Global School-based Health Survey (GSHS) conducted in six African countries between 2003 and 2004.
Setting: Surveys administered in classrooms.
Subjects: The sample included 20765 students at the ages from 13 to 15 years from six African countries (Kenya, Namibia, Swaziland, Uganda, Zambia, Zimbabwe) chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country.
Results: The percentage of adolescents reporting one or more serious injuries within the past 12 months was 68.2% for all countries, ranging from 38.6% in Swaziland to 71.5% in Zambia.
In multivariate regression analysis risk behaviours were associated with annual injury prevalence with the highest odds for loneliness, followed by hunger, truancy, depression, smoking, drug use, non-condom use and excessive drinking. The observed risk for all injuries, sports, motor vehicle, fighting or burns injuries increased consistently and strongly with increasing number of risk behaviours.
Conclusion: High annual injury prevalence was found and risk taking played a role in the etiology of injury. There is a need to consider an integrated approach to injury etiology in planning injury prevention and safety promotion activities among schoolchildren, paying particular attention to lifestyle factors, which have the potential to influence risk for injuries.