Internet addiction prevalence and associated factors among secondary-level private school students in urban Nepal: a cross-sectional study.

Objective: To estimate the prevalence of internet addiction and its associated factors among secondary-level private school students in an urban municipality in Nepal.

Design: Cross sectional.

Setting: Private schools in Budhanilkantha Municipality, Kathmandu District in Nepal.

Participants: 376 secondary-level (grades 9-12) school students.

Outcome Measures: Internet addiction prevalence was the primary outcome measure. We conducted a cross-sectional survey using a self-administered structured questionnaire containing information on participants' sociodemographic profile, technological factors associated with internet use along with Young's internet addiction test, insomnia severity index and depression anxiety stress scales to assess internet addiction and associated factors. Pearson's χ2 tests and binary logistic regression were performed to examine the association between dependent and independent variables at a 5% level of significance.

Result: The prevalence of internet addiction was 51.10% (95% CI 46 to 55.60). Students who lived alone or with friends in an apartment had a higher likelihood of internet addiction compared with those living with their parents (adjusted odds ratio (AOR) 2.89, 95% CI 1.03 to 8.11). On the other hand, students residing in hostels were less likely to be affected (AOR 0.21, 95% CI 0.06 to 0.76). Additionally, spending 2 or more hours online per day was associated with a higher risk of internet addiction (AOR 2.09, 95% CI 1.20 to 3.63) compared with those who spent less than 2 hours per day online. Individuals with severe to extremely severe depression were more likely to have internet addiction (AOR 2.99, 95% CI 1.03 to 8.66) compared with individuals without depressive symptoms. Furthermore, a notable association was observed between internet addiction and insomnia. Individuals who experienced mild to moderate insomnia (AOR 5.19, 95% CI 2.93 to 9.19) and severe insomnia (AOR 21.09, 95% CI 2.09 to 212.91) were at significantly higher risk of internet addiction compared with those without clinically significant insomnia.

Conclusion: Prevalence of internet addiction among school-going adolescents in urban Nepal is high. Living situations, average time spent online, depression and insomnia are potential drivers of internet addiction.