The stable economic development of a country depends on the level of education, the state of health and the optimal well-being of adolescents and young people.

Childhood and adolescence are recognized as periods of learning about health practices and behaviors, particularly in nutrition. Adolescence is the most important period of health. It is undermined by many health problems including overweight and obesity. The World Health Organization (WHO) considers adolescence to be the period of growth and human development that is between childhood and adulthood, between 10 and 19 years of age. Overweight and obesity are serious public health concerns to adolescents.

In fact, overweight and obesity in an adolescent, later predispose him to chronic diseases such as cardiovascular diseases, diabetes, chronic respiratory diseases and cancers [1] . Other consequences of obesity are psychological effects and social stigma faced by obese adolescents, which can have serious consequences for mental and physical health [2] .

Some factual data shows that the school environment influences the consumption of foods and is likely to promote unhealthy eating habits that promote the onset of obesity among students [3] . Besides eating habits, these statuses are as well conditioned by factors such as the practice of physical activity and the involvement of parents, as reported in some studies in developed countries [4] .

In addition, the prevalence of overweight and obesity among adolescents has increased steadily in the different age groups and in most countries in the past decades [5] . Thus, worldwide, in 2010, about 42 million children were overweight with 35 million living in developing countries [6] . The prevalence of overweight and obesity among children and youth is increasing in emerging countries in Africa and Asia [7] .

Overweight and obesity in adolescents, formerly associated with wealth and developed countries [8] [9] , also affect developing countries. In sub-Saharan Africa, among school-aged adolescents, the prevalence of overweight and obesity varies from one country to another. For example, in Nigeria in 2012, 9.7% of adolescents were overweight and [10] while in Senegal in 2011, 9.7% were obese [11] .

Although several studies are being conducted in Western countries on the subject, this is not the case in Africa where the focus is mainly on communicable diseases such as malaria and HIV/AIDS.

In Benin, the nationwide survey of school-based student health, conducted in 2009 in the framework of the Global School-based Student Health Survey (GSHS) showed a prevalence of 8.8% for overweight and 0.4% for obesity [12] . But since then, no further studies have been conducted in the area to provide updated information for better targeted interventions.

It is therefore to contribute to filling this gap in strategic information that the present study was conducted with the objectives of estimating the prevalence of overweight and obesity and identifying the associated factors among school adolescents in Benin.

Our study shows that overweight and obesity among school adolescents are a serious problem in developing countries, particularly in sub-Saharan Africa including Benin. This overweight is significantly related to factors such as gender, age, regular physical activity, consumption of sugary and carbonated beverages, sedentary lifestyle and fruits and vegetables consumption. Considering that the socio-economic development of developing countries depends upon the physical, social and emotional well-being of adolescents, these results argue for taking individual and collective measures to prevent overweight and obesity among school adolescents and thereby the subsequent onset of chronic diseases in their adulthood.

The authors declare no conflicts of interest regarding the publication of this paper.

Houinato, O.A., Kpozehouen, A., Hounkpatin, B., Gbédji, K.Y., Robin, H., Mizéhoun-Adissoda, C., Guédou, F., Houinato, D.S. and Perrin, R.X. (2019) Prevalence and Factors Associated with Overweight and Obesity among Adolescents in Schools in Benin in 2016. Open Journal of Epidemiology, 9, 213-242. https://doi.org/10.4236/ojepi.2019.93018

2016 BENIN SURVEY ON THE STATE OF THE HEALTH FACILITIES OF ADOLESCENTS IN SCHOOL ENVIRONMENTS

This survey is about your health and the things you do that may affect your health. Students like you all over your country are doing this survey. Students in many other countries around the world also are doing this survey. The information you give will be used to develop better health programs for young people like yourself.

DO NOT write your name on this survey or the answer sheet. The answers you give will be kept private. No one will know how you answer. Answer the questions based on what you really know or do. There are no right or wrong answers.

Completing the survey is voluntary. Your grade or mark in this class will not be affected whether or not you answer the questions. If you do not want to answer a question, just leave it blank.

Make sure to read every question. Check the boxes on your answer sheet that match your answer. When you are done, do what the person who is giving you the survey says to do.

Thanks very much for your help.

1) How old are you?

a) 10 years old

b) 11 years old

c) 12 years old

d) 13 years old

e) 14 years old

f) 15 years old

g) 16 years old

h) 17 years old

i) 18 years old

j) 19 years old

2) What is your sex?

a) Male

b) Female

3) In what grade/class/ standard are you?

a) 1^st

b) 2^nd

c) 3^rd

d) 4^th

e) 5^th

f) 6^th

g) 7^th

4) In the last 30 days, who did you live with most of the time?

a) Both, my father or guardian and my mother or guardian

b) Only my father or guardian

c) Only my mother or guardian

d) kinships

e) Internships

f) Friends

The next questions ask about your height and weight,

How tall are you without your shoes on?

ON THE ANSWER SHEET, WRITE YOUR HEIGHT AND WEIGHT

Height (cm):

How much do you weigh without your shoes on?

Weight (kg):

The next questions ask about what you might eat and drink.

5) During the past 30 days, how many times per day did you usually eat fruit, such as pineapple, mango, apple, papaya, orange, avocado or lemon?

a) I did not eat fruit during the past 30 days

b) Less than one time per day

c) 1 time per day

d) 2 times per day

e) 3 times per day

f) 4 times per day

g) 5 or more times per day

6) During the past 30 days, how many times per day did you usually eat vegetables, such as carrots, cabbage, green vegetables (amaranth, vernonia, basil, black plum …), tomato, onion, salad, green beans, sweet pepper?

a) I did not eat vegetables during the past 30 days

b) Less than one time per day

c) 1 time per day

d) 2 times per day

e) 3 times per day

f) 4 times per day

g) 5 or more times per day

7) During the past 30 days, how many times per day did you usually drink carbonated soft drinks, such as Coca – cola, Sprite or Tonic or Sweet Ginger juices (do not count sodas without sugar)

a) I did not drink carbonated soft drink during the past 30 days

b) Less than one time per day

c) 1 time per day

d) 2 times per day

e) 3 times per day

f) 4 times per day

g) 5 or more times per day

8) During the past 7 days, on how many days did you eat food from a fast food restaurant, such as Ice Festival, Cafariat, Debonnaire or King of Chawamar?

a) 0 day

b) 1 day

c) 2 days

d) 3 days

e) 4 days

f) 5 days

g) 6 days

h) 7 days

The next questions ask about cleaning your teeth and washing your hands.

9) During the past 30 days, how many times per day did you usually clean or brush your teeth?

a) I did not clean or brush my teeth during the past 30 days

b) Less than 1 time per day

c) 1 time per day

d) 2 times per day

e) 3 times per day

f) 4 or more times per day

10) During the past 30 days, how often did you wash your hands before eating?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

11) During the past 30 days, how often did you wash your hands after using the toilet or latrine?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

12) During the past 30 days, how often did you use soap when washing your hands?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

13) Is there a drinking water point at the school ?

a) Yes

b) No

14) Is there a place in the school where to wash hands after using the toilet or latrine?

a) There are no toilets or latrines at school

b) Yes

c) No

15) Are the toilets or latrines in the school clean?

a) There are no toilets or latrines at school

b) Yes

c) No

The next question asks about physical attacks. A physical attack occurs when one or more people hit or strike someone, or when one or more people hurt another person with a weapon (such as a stick, knife, or gun). It is not a physical attack when two students of about the same strength or power choose to fight each other.

16) During the past 12 months, how many times were you physically attacked?

a) 0 times

b) 1 times

c) 2 or 3 times

d) 4 or 5 times

e) 6 or 7 times

f) 8 or 9 times

g) 10 or 11 times

h) 12 or more times

The next question asks about physical fights. A physical fight occurs when two students of about the same strength or power choose to fight each other.

17) During the past 12 months, how many times were you in a physical fight?

a) 0 times

b) 1 times

c) 2 or 3 times

d) 4 or 5 times

e) 6 or 7 times

f) 8 or 9 times

g) 10 or 11 times

h) 12 or more times

The next questions ask about serious injuries that happened to you. An injury is serious when it makes you miss at least one full day of usual activities (such as school, sports, or a job) or requires treatment by a doctor or nurse.

18) During the past 12 months, how many times were you seriously injured?

a) 0 times

b) 1 times

c) 2 or 3 times

d) 4 or 5 times

e) 6 or 7 times

f) 8 or 9 times

g) 10 or 11 times

h) 12 or more times

19) During the past 12 months, what was the most serious injury that happened to you?

a) I was not seriously injured during the past 12 months

b) I had a broken bone or a dislocated joint

c) I had a cut or stab wound

d) I had a concussion or other head or neck injury, was knocked out, or could not breathe

e) I had a gunshot wound

f) I had a bad burn

g) I was poisoned or took too much of a drug

h) Something else happened to me

20) During the past 12 months, what was the major cause of the most serious injury that happened to you?

a) I was not seriously injured during the past 12 months

b) I was in a motor vehicle accident or hit by a motor vehicle

c) I fell

d) Something fell on me or hit me

e) I was attacked or abused or was fighting with someone

f) I was in a fire or too near a flame or something hot

g) I inhaled or swallowed something bad for me

h) Something else caused my injury

The next questions ask about bullying. Bullying occurs when a student or group of students say or do bad and unpleasant things to another student. It is also bullying when a student is teased a lot in an unpleasant way or when a student is left out of things on purpose. It is not bullying when two students of about the same strength or power argue or fight or when teasing is done in a friendly and fun way.

21) During the past 30 days, on how many days were you bullied?

a) 0 day

b) 1 or 2 days

c) 3 to 5 days

d) 6 to 9 days

e) 10 to 19 days

f) 20 to 29 days

g) All 30 days

22) During the past 30 days, how were you bullied most often?

a) I was not bullied during the past 30 days

b) I was hit, kicked, pushed, shoved around, or locked indoors

c) I was made fun of because of my race, nationality, or color

d) I was made fun of because of my religion

e) I was made fun of with sexual jokes, comments, or gestures

f) I was left out of activities on purpose or completely ignored

g) I was made fun of because of how my body or face looks

h) I was bullied in some other way

The next questions ask about your feelings and friendships.

23) During the past 12 months, how often have you felt lonely?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

24) During the past 12 months, how often have you been so worried about something that you could not sleep at night?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

25) During the past 12 months, did you ever consider attempting suicide?

a) Yes

b) No

26) During the past 12 months, did you ever seriously consider attempting suicide?

a) Yes

b) No

27) During the past 12 months, how many times did you actually attempt suicide?

a) 0 times

b) 1 time

c) 2 or 3 times

d) 4 or 5 times

e) 6 or more times

28) How many close friends do you have?

a) 0 times

b) 1 time

c) 2 times

d) 3 or more times

The next questions ask about cigarette and other tobacco use.

29) How old were you when you first tried a cigarette?

a) I have never smoked cigarettes

b) 7 years old or younger

c) 8 or 9 years old

d) 10 or 11 years old

e) 12 or 13 years old

f) 14 or 15 years old

g) 16 or 17 years old

h) 18 years old or older

30) During the past 30 days, on how many days did you smoke cigarettes?

a) 0 days

b) 1 or 2 days

c) 3 to 5 days

d) 6 to 9 days

e) 10 to19 days

f) 20 to 29 days

g) All days

31) During the past 30 days, on how many days did you use any tobacco products other than cigarettes, such as pipe, rolled tobacco leaves, snuff powder or chewing tobacco leaves?

a) 0 days

b) 1 or 2 days

c) 3 to 5 days

d) 6 to 9 days

e) 10 to19 days

f) 20 to 29 days

32) During the past 12 months, have you ever tried to stop smoking cigarettes?

a) I have never smoked cigarettes

b) I did not smoke cigarettes during the past 12 months

c) Yes

d) No

33) During the past 7 days, on how many days have people smoked in your presence?

a) 0 days

b) 1 or 2 days

c) 3 to 4 days

d) 5 to 6 days

e) All days

34) Which of your parents or guardians use any form of tobacco?

a) Neither

b) My father or male guardian

c) My mother or female guardian

d) Both

e) I do not know

The next questions ask about drinking alcohol as sodabi, atan, tchoukoutou, Drinking alcohol does not include drinking a few sips of wine for religious purposes. A “drink” is a glass of wine, a bottle of beer, a small glass of liquor, or a mixed drink.

35) How old were you when you had your first drink of alcohol other than a few sips?

a) have never had a drink of alcohol other than a few sips

b) 7 years old or younger

c) 8 or 9 years old

d) 10 or 11 years old

e) 12 or 13 years old

f) 14 or 15 years old

g) 16 or 17 years old

h) 18 years old or older

36) During the past 30 days, on how many days did you have at least one drink containing alcohol?

a) 0 das

b) 1 or 2 days)

c) 3 to 5 days

d) 6 to 9 days

e) 10 to 19 days

f) 20 to 29 days

g) All 30 days

37) During the past 30 days, on the days you drank alcohol, how many drinks did you usually drink per day?

a) I did not drink alcohol during the past 30 days

b) Less than one drink

c) 1 drink

d) 2 drinks

e) 3 drinks

f) 4 drinks

g) 5 or more drinks

38) During the past 30 days, how did you usually get the alcohol you drank? SELECT ONLY ONE RESPONSE.

a) I did not drink alcohol during the past 30 days

b) I bought it in a store, shop, or from a street vendor

c) I gave someone else money to buy it for me

d) I got it from my friends

e) I got it from my family

f) I stole it or got it without permission

g) I got it some other way

Staggering when walking, not being able to speak right, and throwing up are some signs of being really drunk.

39) During your life, how many times did you drink so much alcohol that you were really drunk?

a) 0 times

b) 1 or 2 times

c) 3 to 9 times

d) 10 or more times 40) During your life, how many times have you got into trouble with your family or friends, missed school, or got into fights, as a result of drinking alcohol?

a) 0 times

b) 1 or 2 times

c) 3 to 9 times

d) 10 or more times

The next questions ask about drug use. This includes using marijuana, amphetamines, cocaine, inhalants, cannabis

41) How old were you when you first used drugs?

a) I have never used drugs

b) 7 years old or younger

c) 8 or 9 years old

d) 10 or 11 years old

e) 12 or 13 years old

f) 14 or 15 years old

g) 16 or 17 years old

h) 18 years old or older

42) How many times in your life did you take cannabis?

a) 0 times

b) 1 or 2 times

c) 3 to 9 times

d) 10 to 19 times

e) 20 times and more

43) In the last 30 days, how many times have you taken cannabis?

a) 0 times

b) 1 or 2 times

c) 3 to 9 times

d) 10 to 19 fois

e) 20 or more times

44) How many times in your life did you take amphetamine (also called stimulants, products not prescribed by a doctor)?

a) 0 times

b) 1 or 2 times

c) 3 to 9 times

d) 10 to 19 times

e) 20 or more times

The next questions ask about sexual intercourse.

45) Have you ever had sexual intercourse?

a) Yes

b) No

46) How old were you when you had sexual intercourse for the first time?

a) Je n’ai jamais eu de relation sexuelle

b) 11 years old or younger

c) 12 years old

d) 13 years old

e) 14 years old

f) 15 years old

g) 16 or 17 years old

h) 18 years old or older

47) During your life, with how many people have you had sexual intercourse?

a) I have never had sexual intercourse

b) 1 person

c) 2 people

d) 3 people

e) 4 people

f) 5 people

g) 6 or more people

48) The last time you had sexual intercourse, did you or your partner use a condom ?

a) I have never had sexual intercourse

b) Yes

c) No

49) The last time you had sexual intercourse, did you or your partner use any other method of birth control, such as withdrawal, rhythm (safe time), birth control pills, or any other method to prevent pregnancy?

a) I have never had sexual intercourse

b) Yes

c) No

d) I don’t know

50) How often do you or your partner use a condom or condom when you have sex?

a) I have never had sexual intercourse

b) Never

c) Rarely

d) Sometimes

e) Most of the time

f) Always

51) With whom do you have sexual intercourse?

a) I have never had sexual intercourse

b) Only women

c) Only men

d) Women and men

52) Last time you have sexual intercourse, did you drink alcohol or take various drugs before?

a) I have never had sexual intercourse

b) Yes

c) No

53) How many times have you been pregnant (ONLY FOR GIRLS)?

a) 0 times

b) 1 time

c) 2 or more times

d) Don’t know

The next questions ask about physical activity. Physical activity is any activity that increases your heart rate and makes you breathe hard. Physical activity can be done in sports, playing with friends, or walking to school. Some examples of physical activity are running, fast walking, biking, dancing, football, and others.

54) During the past 7 days, on how many days were you physically active for a total of at least 60 minutes per day? ADD UP ALL THE TIME YOU SPENT IN ANY KIND OF PHYSICAL ACTIVITY EACH DAY.

a) 0 days

b) 1 day

c) 2 days s

d) 3 days

e) 4 days

f) 5 days

g) 6 days

h) 7 days

55) During this school year, on how many days did you go to physical education (PE) class each week?

a) 0 days

b) 1 day

c) 2 days

d) 3 days

e) 4 days

f) 5 or more days

The next question asks about the time you spend mostly sitting when you are not in school or doing homework.

56) How much time do you spend during a typical or usual day sitting and watching television, playing computer games, talking with friends, or doing other sitting activities, such as playing cards or playing domino?

a) Less than 4 hours per day

b) More than 4 hours per day

The next questions ask about your experiences at school and at home.

57) During the past 30 days, on how many days did you miss classes or school without permission?

a) 0 days

b) 1 or 2 days

c) 3 to 5 days

d) 6 to 9 days

e) 10 or more days

58) During the past 30 days, how often were most of the students in your school kind and helpful?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

59) During the past 30 days, how often did your parents or guardians check to see if your homework was done?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

60) During the past 30 days, how often did your parents or guardians understand your problems and worries?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

61) During the past 30 days, how often did your parents or guardians really know what you were doing with your free time?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

62) During the past 30 days, how often did your parents or guardians go through your things without your approval?

a) Never

b) Rarely

c) Sometimes

d) Most of the time

e) Always

63) Department

a) Alibori

b) Atacora

c) Atlantique

d) Borgou

e) Collines

f) Couffo

g) Donga

h) Littoral

i) Mono

j) Ouémé

k) Plateau

l) Zou

64) Areas of résidence

a) Rural

b) Urban

The next questions ask about abortion and masturbation

65) How many times have you had a proposed abortion?

a) 0 times

b) 1 time

c) 2 times ans more

66) Have you ever been able to masturbate?

a) Yes

b) No

67) In the last 12 months, how many times have you ever been able to masturbate?

a) 0 times

b) 1 time

c) 2 or 3 times

d) 4 to 9 times

e) 10 to 29 times

f) 30 times and more