Serious non-fatal unintentional injuries among in-school adolescents in Sri Lanka: results from the 2016 Sri Lankan global school-based health survey.

BACKGROUND: Unintentional injuries among adolescents is a major public health problem the world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; it is also the leading cause of death among adolescents in the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13-17 years using data from the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka. METHODS: A cross-sectional survey was conducted using a self-administered questionnaire, among 3262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected using probabilities proportional to school enrollment size, from all schools in the country that have classes in grades 8-12. Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. The weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates. RESULTS: During the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured one or more times. The injuries were more common among males, but were equally common among the two different age groups (13-15 age group vs 16-17 age group). The most common type of injury was cut or stab wounds (5.5%), followed by broken bones/dislocated joints (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as being of the male sex, being bullied, being physically attacked, and/or being in a physical fight. CONCLUSION: This study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration when designing school-based interventions to prevent adolescent injuries.

Prevalence and Correlates of Interpersonal Violence Among In-School Adolescents in Sri Lanka: Results From the 2016 Sri Lankan Global School-Based Health Survey.

Interpersonal violence among adolescents is an issue of global public health concern, leading to adverse physical and psychological outcomes among children and young people under the age of 18 years. This article discusses the prevalence of interpersonal violence and identifies their associated factors among school-going adolescents of ages 13 to 17 years using the data from the Sri Lankan Global School-Based Health Survey conducted in 2016. Of the 3262 students who participated, 35.1% (95% confidence interval = 31.0% to 39.5%) were physically attacked and 44.2% (95% confidence interval = 39.2% to 49.4%) were in a fight with peers, one or more times during the 12 months prior to the survey. Being bullied by peers, male sex, 13 to 15 years age group, smoking and alcohol use, considering or attempting suicide, missing classes without permission, and parents not being aware of students' activities were associated with violence. The study highlights the need for violence prevention programs to address the risk factors among school-going adolescents.