Osaghae Ikponmwosa, Bhuiyan Md Al-Amin, Alonge Olakunle
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of IDRC-B, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.
BMJ Paediatr Open. 2020 May 24;4(1):e000676. doi: 10.1136/bmjpo-2020-000676. eCollection 2020.
To determine the predictors of non-fatal violence or assault among adolescents in rural Bangladesh to inform evidence-based interventions.
Cross-sectional study.
Household survey and national census in 51 unions of rural Bangladesh.
213 782 adolescents aged 11-19 years who reported violence during a population-based survey in 2013. We used logistic regression to determine the prevalence of factors that predict non-fatal forms of violence or assaults among adolescents. Assault or violence was defined as all injuries inflicted directly by another person or resulting from collateral impact over a 6-month recall period.
457 (0.21%) cases of violence or assault were reported. The adjusted prevalence ratio (PR) of violence was lower among female adolescents compared with males (PR: 0.60, 95% CI 0.47 to 0.78, p<0.001). Compared with the lowest socioeconomic quintile, being in a higher quintile was associated with lower prevalence of violence, with a 39% decrease in the adjusted prevalence of violence among adolescents in highest compared with lowest socioeconomic index (PR: 0.61, 95% CI 0.44 to 0.84). The adjusted prevalence of violence in Chandpur and Comilla districts was 7.30 times and 7.27 times higher respectively than the prevalence of violence in Sirajganj (PR: 7.30, 95% CI 4.07 to 13.10 and PR: 7.27, 95% CI 3.56 to 14.84, respectively). There was no significant difference in the adjusted prevalence of violence occurring in school compared with home (PR: 1.19, 95% CI 0.85 to 1.69).
Male adolescents may be at an increased risk of suffering violence, and socioeconomic factors and place (districts) are strong predictors of adolescent violence among a selected population in rural Bangladesh. These findings are important in guiding interventions to address the burden of violence among adolescents in communities with similar demographics as our study population. Further research is needed to identify the actual burden of violence among adolescents at national level and to establish an effective violence prevention programme across Bangladesh.
确定孟加拉国农村青少年非致命暴力或攻击行为的预测因素，为循证干预提供依据。
横断面研究。
孟加拉国农村51个联合乡的家庭调查和全国人口普查。
参与者、方法及主要结果：2013年在一项基于人群的调查中报告有暴力行为的213782名11至19岁青少年。我们使用逻辑回归来确定预测青少年非致命性暴力或攻击行为的因素的患病率。攻击或暴力行为定义为在6个月回忆期内由他人直接造成的所有伤害或间接影响导致的伤害。
报告了457例（0.21%）暴力或攻击行为。与男性青少年相比，女性青少年暴力行为的调整患病率较低（患病率比：0.60，95%置信区间0.47至0.78，p<0.001）。与社会经济最低五分位数相比，处于较高五分位数与暴力患病率较低相关，与社会经济指数最低的青少年相比，最高社会经济指数的青少年暴力调整患病率降低了39%（患病率比：0.61，95%置信区间0.44至0.84）。钱德布尔和科米拉地区的暴力调整患病率分别比锡拉杰甘杰地区高7.30倍和7.27倍（患病率比分别为：7.30，95%置信区间4.07至13.10；7.27，95%置信区间3.56至14.84）。在学校发生暴力的调整患病率与在家中相比无显著差异（患病率比：1.19，95%置信区间0.85至1.69）。
男性青少年遭受暴力的风险可能更高，社会经济因素和地点（地区）是孟加拉国农村特定人群中青少年暴力行为的有力预测因素。这些发现对于指导干预措施以应对与我们研究人群人口统计学特征相似的社区中青少年暴力负担具有重要意义。需要进一步研究以确定国家层面青少年暴力的实际负担，并在孟加拉国建立有效的暴力预防计划。
