Trauma exposure and post-traumatic stress symptoms in urban African schools: Survey in Cape Town and Nairobi

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.