Irshad Ali Shaikh  ( Apartment No. 32, Building No. 3, Group No. 71, Al Rehab, Cairo,Egypt )
Masood Ali Shaikh  ( Apartment No. 32, Building No. 3, Group No. 71, Al Rehab, Cairo,Egypt )
Zulfiqar Siddiqui  ( 268-B, Kamal Road, Cantt. Rawalpindi )

Madam, The substantial burden of disease associated with injuries is "under-recognized" globally.¹ In United States, injuries are responsible for more deaths in adolescents than all other diseases combined and about fifteen thousand adolescents (10-19 years old) die each year as a result of injuries.² In the Eastern-Mediterranean Region; injuries were responsible for over 30% of disease burden in 15-44 year old males.³ While medically-attended injuries in the preceding twelve-months were reported by over 40% of grade 7-8 female students in a study conducted in Islamabad.⁴
To describe gender, considering attempting suicide in the past twelve-months, bullying experience, having felt so sad or hopeless for almost everyday for two weeks or more so as to have stopped doing usual activities in the past twelve months, number of close friends, and understanding of one's problems/worries by the parents/guardians, associated with self reported unintentional and intentional serious injuries in the past twelve months in grade 8-10 students in Jordan and its percentages; we used data from the Global School-based Student Health Survey for Jordan (GSHS-Jordan) conducted in 2004 by the Jordanian Ministry of Health.⁵ We selected all the respondents in grade 8-10, who responded to the question "During the past 12 months, how did the most serious injury happen to you?" Students responding as either not seriously-injured, I hurt myself by accident, someone hurt me by accident, I hurt myself on purpose, or someone hurt me on purpose. These five-response categories were recoded into no-serious-injury, unintentional-injuries, or intentional-injuries in the past twelve months. A two-stage cluster sample design was adopted for the GSHS-Jordan to produce nationally representative estimates for all students in grade 8-10. Using SUDAAN, Ordered logistic regression to identify factors associated with serious injuries among students and adjusted Odds Ratios (aOR) were computed.
The percentage of grade 8-10 students reporting no serious injury in the past twelve months was 64.94% and Standard Error (SE) was 1.66 (n=2406), while 28.30% (SE 1.39) reported  unintentional injuries and 6.76% (SE 0.79) reported intentional injuries. Adjusting for other variables present in the model, students who seriously considered attempting suicide were less likely to have sustained serious injury in the past twelve months (aOR = 0.59; 95% CI: 0.42, 0.81) compared to students who did not report such consideration. Odds of having sustained serious injury were lower in male students (aOR 0.42; 95% CI: 0.34, 0.52.) compared to female. Similarly students who did not report having ever felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities in the preceding twelve months were also less likely to have sustained serious injury (aOR=0.56; 95% CI: 0.45, 0.70) compared to students who answered this question affirmatively. While students who were not bullied on one or more days during the past thirty days were more likely to have sustained serious injury (aOR 2.61; 95% CI: 1.78, 3.81) compared to those who did report being bullied.
However, results indicate that parent's understanding of a student's problems/worries, or the number of close friends a student has, were not statistically significant predictors of self reported serious injuries in the past twelve months.
The results demonstrate that 8-10th grade students in Jordan, were more likely to report having sustained serious unintentional as well as intentional injuries in the past twelve months, if they were not bullied in the past thirty days. Additionally being male, having seriously considered attempting suicide in the past twelve months, or students who did not report having ever felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities in the preceding twelve months bestowed protection from having sustained serious injury in the past twelve months.

1.  Murray CJ, Lopez AD. Global mortality, disability and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997; 349: 1436-42.
2.  Runyan CW, Gerken EA. Epidemiology and prevention of adolescent injury: a review and research agenda. JAMA 1989; 2273-9.
3.  The World Health Report 2003 - Shaping the future. [online] 2008. Available from: URL: http://www.who.int/whr/2003/em/
4.  Shaikh MA, Shaikh IA. Injury profile in young female adolescents - A case study from Islamabad. JAMC 2005; 17: 15-7.
5.  Jordan. [online] 2007 [cited 2007 August 11]. Available from: URL:  http://www.cdc.gov/gshs/countries/jordan/index.htm