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The British Journal of Psychiatry (2004) 184: 169-175
© 2004 The Royal College of Psychiatrists

Trauma exposure and post-traumatic stress symptoms in urban African schools

Survey in CapeTown and Nairobi

S. Seedat, FCPsych

MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, CapeTown, South Africa

C. Nyamai, MScPsych and F. Njenga, FRCPsych

Chiromo Lane Medical Center, Nairobi, Kenya

B. Vythilingum, MBChB and D. J. Stein, FRCPC PhD

MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, CapeTown, South Africa

Correspondence: S. Seedat, MRC Unit on Anxiety and Stress Disorders, PO Box 19063, Tygerberg 7505, CapeTown, South Africa. Tel: 21 9389374; fax: 21 9335790; e-mail: sseedat{at}sun.ac.za.

Declaration of interest None.

Funding detailed in Acknowledgements.

Background There is a lack of comparative data on the prevalence and effects of exposure to violence in African youth.

Aims We assessed trauma exposure, post-traumatic stress symptoms and gender differences in adolescents from two African countries.

Method A sample of 2041 boys and girls from 18 schools in CapeTown and Nairobi completed anonymous self-report questionnaires.

Results More than 80% reported exposure to severe trauma, either as victims or witnesses. Kenyan adolescents, compared with South African, had significantly higher rates of exposure to witnessing violence (69% v. 58%), physical assault by a family member (27% v. 14%) and sexual assault (18% v. 14%). But rates of current full-symptom post-traumatic stress disorder (PTSD) (22.2% v. 5%) and current partial-symptom PTSD (12% v. 8%) were significantly higher in the South African sample. Boys were as likely as girls to meet PTSD symptom criteria.

Conclusions Although the lifetime exposure to trauma was comparable across both settings, Kenyan adolescents had much lower rates of PTSD. This difference may be attributable to cultural and other trauma-related variables. High rates of sexual assault and PTSD, traditionally documented in girls, may also occur in boys and warrant further study.


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