Predictors of non-fatal violence or assault among adolescents in rural Bangladesh: cross-sectional study.

Objective: To determine the predictors of non-fatal violence or assault among adolescents in rural Bangladesh to inform evidence-based interventions.

Design: Cross-sectional study.

Setting: Household survey and national census in 51 unions of rural Bangladesh.

Participants Methods And Main Outcome: 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.

Results: 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).

Conclusion: 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.