Demographic and contextual infl uences in injury risk among adolescents in a low-income country setting: Results from a school-based survey in Tanzania

Abstract

Objective: This study investigated the social, demographic and contextual factors associated with injury among adolescents in a low-income urban sub-Saharan African setting.

Methods: Data on 2 176 adolescents aged 11–16 years were divided into three groups: Those that reported not being injured, those that had been injured once, and those that had been injured multiple times within a 12-month recall period. We conducted bivariate analyses to screen for associations with several social, demographic and contextual factors. Then a multinomial logistic regression was performed to examine associations while adjusting for covariates.

Results: Within the recall period, 22.14% of participants reported one serious injury and 10.96% reported multiple injuries. Compared with non-injured participants, those injured two or more times were mainly male (relative risk ratio (RRR) = 1.71 [1.27–2.31]), younger (RRR = 0.77 [0.68–0.86]), depressed (RRR = 1.98 [1.43–2.74]) and had high rates of truancy (RRR = 2.56; CI = 1.71–3.84). A travel time of more than 30 minutes to and from school was also associated with increased rates of injury (RRR = 1.61; CI = 1.13–2.29).

Conclusions: Injuries are an important source of morbidity among school-attending adolescents in Dar es Salaam. The findings support more research into the contextual factors that predispose adolescents to excessive injury in the region. School settings have the potential to provide safety education in the region.

Keywords: injury, sub-Saharan Africa, urban setting, school health