Prevalence and associated factors of loneliness among in-school adolescents in three South Asian countries.

We aimed to determine the prevalence and factors associated with loneliness among adolescent students in three South Asian countries. We used data from the latest Global School-Based Health Survey of Afghanistan, Bangladesh, and Pakistan. A two-stage cluster sampling design was used to collect the cross-sectional survey data. Data from 8 089 in-school adolescents were analysed using STATA 14.0. Among all the participants, the prevalence of loneliness was 14.9%. The prevalence of loneliness was significantly higher in females (19.7%), Afghan adolescents (35.5%), participants having anxiety-induced sleep disturbance (51.4%), often experiencing bullying (28.9%), feeling hungry often or always (23.9%), suffering parental emotional neglect (21.2%), and spending ≥ 8 hours/day leisure time (35.8%), than their counterparts. The final adjusted model of multiple logistic regression showed that females (OR = 1.36, 95% CI: 1.02 -1.80), having no close friends (OR = 2.00, 95% CI: 1.30 - 3.10), having an anxiety-induced sleep disturbance (OR = 5.25, 95% CI: 3.75 - 7.34), being bullied 1 to 2 days in the past month (OR = 2.13, 95% CI: 1.60 - 2.84), being physically attacked 2 or more times in the past year (OR = 1.69, 95% CI: 1.26 - 2.26), suffering parental emotional neglect (OR = 1.67, 95% CI: 1.18-2.34), and current tobacco user (OR = 2.70, 95% CI: 1.39 - 5.25) had significantly higher odds of having loneliness. We found a higher prevalence of loneliness and identified several risk factors among in-school adolescents in three South Asian countries. To reduce loneliness among in-school adolescents, target-oriented interventions, such as peer, parental, and counselling support, are needed at schools.