Health  Vol.5 No.12 , December 2013
High rate of injuries among students in Southern Nigeria: An urgent call to action

Addressing injury and its associated effects is a multi-dimensional and ongoing challenge. This includes recognizing that injury is a significant public health problem capable of affecting the health and wellbeing of all populations over short and longer terms, albeit in varied ways and intensities. That recognition has drawn attention to the need to take actions to avert its rate of occurrence particularly in developed nations. While in low-income countries, despite the growing burden of injury, there are few school-based studies from which to develop prevention initiatives. Thus this study describes the cause, nature and types and prevalence of injuries in a cross sectional population of students in Southern Nigeria, in order to provide data for use in developing priorities for injury prevention efforts. An interviewer-administered school-based survey of students attending schools in Southern Nigeria was conducted in 2013. The study sample involved 585 students (60.9% male, 39.2% female and overall mean age of 15 years). We inquired about participants self-reported injuries in the past one year (all injury inclusive). When reported, injuries were further assessed according to cause, intent, nature, type, place, and number of days absent from school due to injury. Overall, there were 549 self-reported injuries

in the past one year (93.8%) among the respondents (95.5% for males and 90.8% for females, p = 0.6696). Sex wise, prevalence of injury differ by age, school setting and parents’ occupation (p < 0.05). Falls 293 (53.4%) was the leading cause of injury. Falls and animal bites were significantly higher in males compared to females [206 (60.4%) vs 87 (41.8%) p = 0.002, and 10 (2.9%) vs 0 (0.0) p = 0.016] respectively. Traffic injuries and falls decrease progressively with age. Homes and schools were settings injuries occurred mostly. Over 68% of the reported injuries were unintentional. On the average, 2 days of normal school activity were lost per injured persons because of an injury. Given the high prevalence of injury reported in this study, injury like tropical diseases, should be considered a significant public health problem in Nigeria. We expect that this school-based information will be useful in establishing rational priorities for prevention, and the targeting of interventions toward responsible authorities. Also, there is a high need for safety education aiming to educate this young population on how to prevent injury.


Cite this paper: Nmor, J. , Nwaka, K. , Goto, K. , Toyosawa, J. and Fujita, D. (2013) High rate of injuries among students in Southern Nigeria: An urgent call to action. Health, 5, 1965-1975. doi: 10.4236/health.2013.512266.

[1]   World Health Organization (2008) Violence, injuries, and disability: Biennial 2006-2007 report. World Health Organization, Geneva.

[2]   Sethi, D., Habibula, S., McGee, K., Peden, M., Bennett, S., Hyder, A.A., Klevens, J., Odero, W. and Suriyawongpaisal, P. (2004) Guidelines for conducting community surveys on injuries and violence. World Health Organization.

[3]   Murray, C.J. and Lopez, A.D. (1997) Alternative projections of mortality and disability by cause 1990-2020: Global burden of disease study. Lancet, 349, 1498-1504.

[4]   Maziak, W., Ward, K.D. and Rastam, S. (2006) Injuries in Aleppo, Syria; first population-based estimates and characterization of predominant types. BMC Public Health, 6, 63.

[5]   Fatmi, Z., Hadden, W.C., Razzak, J.A., Qureshi, H.I., Hyder, A.A. and Pappas, G. (2007) Incidence, patterns and severity of reported unintentional injuries in Pakistan for persons five years and older: Results of the National Health Survey of Pakistan 1990-94. BMC Public Health, 7, 152.

[6]   Hafman, K., Primack, A., Keusch, G. and Hrynkow, S. (2005) Global health concerns: Addressing the growing burden of trauma and injury in low and middle-income countries. American Journal of Public Health, 95, 13-17.

[7]   Olawale, O.A. and Owoaje, E.T. (2007) Incidence and pattern of injuries among residents of a rural area in South-Western Nigeria: A community-based study. BMC Public Health, 7, 246.

[8]   Ghaffar, A., Hyder, A.A. and Masud, T.I. (2004) The burden of road traffic injuries in developing countries: The first national survey of Pakistan. Public Health, 118, 211-217.

[9]   Hang, H.M., Ekman, R., Bach, T.T., Byass, P. and Svanstrom, L. (2003) Community-based assessment of unintentional injuries: A pilot study in rural Vietnam. Scandinavian Journal of Public Health, 62, 38-44.

[10]   Pickett, W., Michal, M.K., Simpson, I.J., Emmanuel, K.J., Mazur, Y.H. and William, F.B. (2005) Cross national study of injury and social determinants in adolescents. Injury Prevention, 11, 213-218.

[11]   Marcenes, W. and Zabot, T. (2001) Socio-economic correlates of traumatic injuries to the permanent incisors in schoolchildren aged 12 years in Blumenau, Brazilian. Dental Traumatology, 17, 218-222.

[12]   Jildeh, C., Abdeen, Z., Sabbah, H.A. and Philalithis, A. (2013) Unintentional injuries among school-aged children in Palestine: Findings from the national study of palestinian schoolchildren (HBSC-WBG2006). International Journal of Population Research, 2013.

[13]   Owoeye, O.B., Akodu, A.K., Oladokun, B.M. and Akinbo, S.R. (2012) Incidence and pattern of injuries among adolescent basketball players in Nigeria. Sports Medicine, Arthroscopy, Rehabilitation, Therapy and Technology, 4, 15.

[14]   Butchart, A., Kruger, J. and Lekoba, R. (2000) Perceptions of injury causes and solutions in a Johannesburg township: Implications for prevention. Social Science and Medicine, 50, 331-344.

[15]   Ibrahim, J.M., Day, H., Hirshon, JM. and El-Setouhy, M. (2012) Road risk-perception and pedestrian injuries among students at Ain Shams University, Cairo, Egypt. Journal of Injury and Violence Research, 4, 65-72.

[16]   Pickett, W., Garner, M.J., Boyce, W.F. and King, M.A. (2002) Gradients in risk for youth injury associated with multiple-risk behaviours: A study of 11,329 Canadian adolescents. Social Science and Medicine, 55, 1055-1068.

[17]   Pickett, W., Schmid, H., Boyce, W.F., Simpson, K., Scheidt, P.C., Mazur, J., Molcho, M., King, M.A., Godeau, E., Overpeck, M., Aszmann, A., Szabo, M. and Harel, Y. (2002) Multiple risk behavior and injury: An international analysis of young people. Archives of Pediatrics and Adolescent Medicine, 156, 786-793.

[18]   Bergman, A.B. and Rivara, F.P. (1991) Sweden’s experience in reducing childhood injuries. Pediatrics, 88, 69-74.

[19]   Onwuachi-Saunders, C., Samuel, N.F., Patricia, W. and Cimon, B. (1999) Child death reviews: A gold mine for injury prevention and control. Injury Prevention, 5, 276-279.

[20]   Khan, U.R., Bhatti, J.A., Zia, N. and Farooq, U. (2013) School-based injury outcomes in children from a lowincome setting: Results from the pilot injury surveillance in Rawalpindi city, Pakistan. BMC Research Notes, 6, 86.

[21]   Udoh, D.O. and Adeyemo, A.A. (2013) Traumatic brain injuries in children: A hospital-based study in Nigeria. African Journal of Paediatrics and Surgery, 10, 154-159.

[22]   Currie, C.E., Williams, J.M., Wright, P., Beattie, T. and Harel, Y. (1996) Incidence and distribution of injury among schoolchildren aged 11-15. Injury Prevention, 2, 21-25.

[23]   Towner, E.M.L., Jarvis, S.N., Walsh, S.S.M. and AynsleyGreen, A. (1994) Measuring exposure to injury risk in schoolchildren aged 11-14. Bio Medical Journal, 308, 449-452.

[24]   Peltzer, K. (2006) Injury and lifestyle factors among school-aged black and white South African children in the Limpopo Province. Journal of Injury Violence and Prevention, 4, 15-25.

[25]   Starkuniviene, S. and Zaborski, A. (2005) Links between accidents and lifestyle factors among Lithuanian schoolchildren. Medicina, 41, 73-80.

[26]   Peltzer, K. (2008) Injury and social determinants among in-school adolescents in six African countries. Injury Prevention, 14, 381-388.

[27]   Li, X.-S., Xuan, Y.-Q. and Zhu, M. (1997) An investigation on the epidemiology of injuries in middle school students. Chinese Journal of Epidemiology, 18, 146-149.

[28]   Moshiro, C., Ivar, H., Anne, N.A., Philip, S., Yusuf, H. and Gunnar, K. (2005) Injury morbidity in an urban and a rural area in Tanzania: An epidemiological survey. BMC Public Health, 5, 11.

[29]   Hampson, S.E., Andrews, J.A. and Barckley, M. (2008) Childhood predictors of adolescent marijuana use: Early sensation-seeking, deviant peer affiliation, and social images. Addiction and Behavior, 33, 1140-1147.

[30]   Balan, B. and Lingam, L. (2012) Unintentional injuries among children in resource poor settings: Where do the fingers point? Archives of Disease in Childhood, 97, 35-38.

[31]   Ball, I.L., Farnill, D. and Wangeman, J.F. (1984) Sex and age differences in sensation seeking: Some national comparisons. British Journal of Psycholology, 75, 257-265.

[32]   Zuckerman, M., Eysenck, S.B. and Eysenck, H.J. (1978) Sensation seeking in England and America: Cross-cultural, age, and sex comparisons. Journal of Consulting and Clinical Psychology, 46, 139.

[33]   Zhou, L., Chen, D. and Dong, G. (2013) Characteristics and related factors of nonfatal injuries among adolescents and college students in Shenzhen city of China. BMC Public Health, 13, 392.

[34]   Boles, R.E., Roberts, M.C., Brown, K.J. and Mayes, S. (2005) Children’s risk taking behaviors: The role of childbased perceptions of vulnerability and temperament. Journal of Pediatrics and Psychology, 30, 562-570.

[35]   Janson, S., Aleco, M., Beetar, A., Bodin, A. and Shami, S. (1994) Accident risks for suburban preschool Jordanian children. Journal of Tropical Paediatrics, 40, 88-93.

[36]   Broides, A. and Assaf, M. (2003) Home accidents in Arab Bedouin children in southern Israel. Journal of Child Health Care, 7, 207-214.

[37]   World Health Organization (2013) Falls.

[38]   Black, K., Asbridge, M. and Lea, S. (2009) An overview of injuries to adolescents and young adults related to substance use: Data from Canadian emergency departments. Canadian Journal of Emergency Medicine, 11, 330-336.

[39]   Mock, C.N., Abantanga, F., Cummings, P. and Koepsell, T.D. (1999) Incidence and outcome of injury in Ghana: A community-based survey. Bulletin of World Health Organization, 77, 955.

[40]   Forjuoh, S.N., Zwi, A.B. and Mock, C.N. (1998) Injury control in Africa: Getting governments to do more. Tropical Medicine and International Health, 3, 349-356.