Anxiety among urban, semi-urban and rural school adolescents in Dhaka, Bangladesh: Investigating prevalence and associated factors

BACKGROUND: Anxiety disorder is one of the emerging public health problems in many low- and middle-income countries (LMICs). Likewise, in Bangladesh, a growing number of adolescents are experiencing such symptoms though we have very limited research evidence available. The purpose of this study was to investigate the prevalence of anxiety and the factors associated with this condition among urban, semi-urban, and rural school adolescents in Bangladesh. METHODS: This cross-sectional study used a two-stage cluster sampling procedure. A self-administered questionnaire was conveyed to 2355 adolescents from nine secondary schools of Dhaka, Bangladesh. Of the respondents, 2313 completed the seven-item Generalized Anxiety Disorder (GAD-7). Besides, sociodemographic information, self-reported body image as well as modification of Leisure Time Exercise Questionnaire (LTEQ) and WHO Global PA Questionnaire (GPAQ) were used to determine the sociodemographic and lifestyle factors associated with anxiety among adolescents. RESULTS: A total of 20.1% of adolescents were experiencing moderate to severe anxiety; of them, a significantly higher proportion (49.9%) of female adolescents were suffering more than males (40.1%). Furthermore, age, student's grade, father's educational level, number of family members, and residential setting were found to be significantly associated with anxiety among adolescents. In terms of lifestyle factors, irregular physical activity (AOR: 1.31; 95% CI: 1.05-1.63), high screen time (AOR: 1.51; 95% CI:1.21-1.88), sleep dissatisfaction (AOR: 3.79; 95% CI: 3.02-4.76), and underweight body image (AOR: 2.37; 95% CI:1.70-3.28) were found to be significantly associated with anxiety among school adolescents of urban, semi-urban, and rural residential settings. CONCLUSIONS: Anxiety is prevalent among urban, semi-urban, and rural school adolescents in Dhaka, Bangladesh. To lessen this prevalence of anxiety among Bangladeshi adolescents, evidence-based health programs- healthy school trials-and policies should therefore be taken based on the findings of this study.