The study sought to examine the prevalence and correlates of serious injuries among student adolescents in Mauritius. We found a 39% prevalence of serious injuries among these school-going age adolescents. Moreover, being a male, experiencing physical attacks, being bullied, having suicide ideation, experiencing hunger, playing truancy from school, marijuana and alcohol intake, and parental neglect contributed significantly to severe injuries among the adolescents. Using a nationwide representative sample of adolescents of school-going age between grades 8–12, the overall prevalence of serious injuries found among the adolescents of school-going age in Mauritius was relatively low (39%) as compared with the rates found in Ghana (66.0%) [7] and Liberia (71.6%) [13]. However, this value is higher than the prevalence of injuries recorded in Canada (2.4%) [20]. Nonetheless, the prevalence of serious injuries in Mauritius is similar to that found in China (38%) [9]. This prevalence gives the impression that adolescent behaviours that brought the injuries and related controlling factors in Mauritius need attention.

The current study further showed that demographic factors like sex or gender were significantly associated with serious injuries among these adolescents in Mauritius [7, 9, 13, 20, 21]. From our results, males were more likely to be injured than females. Several studies have reported varied results regarding the role sex differences play in increasing the likelihood of sustaining serious injuries among adolescents. For example, our finding was supported by Jildeh et al.'s [21] observation among school-aged children in Palestine. Accordingly, the study suggested that an increase in male-related injuries was influenced by the nature of sports injuries reported in the study, where the males were likely to play contact and aggressive games [21]. However, our current finding contradicts the recent cross-sectional studies of Ghanaian [7] and Liberian [13] adolescents using GSHS datasets as there was no significant association between sex and serious injuries. The variances in results might have occurred due to the differences in locations, with cultural and socioeconomic variations.

Aside from sex differences, the current study also reported a significant association between serious injuries and personal factors like hunger and truancy among adolescents. The link between hunger and injury behaviours has been observed by Probst et al. [22] across 89 countries. They reported a positive significant dose-response association between hunger and gender on injury due to interpersonal violence. For instance, there was a 30% and 50% increase in male and female odds of injury occurrence, respectively. Therefore, as adolescents get hungry, whether male or female, their interpersonal violence equally rises with related injuries. Similarly, behavioural problems like bully victimisation and physical fights positively correlated with severe injuries among adolescents.

Using the 2010 data from GSHS, it found that about 34% of the adolescent students from Oman also experienced injuries such as fractures and joint dislocation in the preceding year that caused at least a day absence from usual activities or required medical attention [23]. Also, the study reported that 38.4%, 38.8%, and 47.6% of adolescents were bullied at school, physically attacked, and involved in physical fights. Although these aggressive behaviours affected both boys and girls, males were worst affected than females. However, previous evidence among Ghanaian in-school adolescents suggested that the bully resulted from peer victimisation [24]. Such bullying included making fun of the victim with sexual jokes, comments, or gestures that affected both genders, but girls were more likely to have experienced much more than boys [23]. Yet, a more recent study from Portugal [25] revealed that more girls get involved in physical fights than boys, though the current study did not analyse that difference. These negative behaviours among adolescents tend to cause health challenges to them. Furthermore, they could lead to other maladaptive behaviours like using substances including alcohol, tobacco, and other hard drugs and high-level adulthood violence [24].

Evidence from the current findings further indicated that adolescents who experienced minimal parental care, who were bullied at school, wre physically attacked, and conceived suicidal thoughts, were likely to report severe injuries. This finding may have occurred as adolescents' low parental care and psychosocial vulnerability are associated with adverse psychosocial outcomes like suicide [7]. Moreover, the bullied and those physically attacked could retaliate, a situation that can result in fights and attendant injuries. It is essential to recognise that these actions are traumatising and psychologically degrading, leading to suicidal ideation [7], exposing adolescents to these maladaptive behaviours. Therefore, the occurrence of serious injuries can become cyclical until drastic and pragmatic actions are taken to reduce or eliminate the effects of notable explanatory factors. The evidence further suggests that significant correlations exist among explanatory variables in several similar GSHS studies [7, 13, 26]. For example, adolescents who attempted suicide reported relationship problems with family members more often [27] and even abused substances [7]. This finding also calls for more parent-school management collaboration to address factors like the nature of parental care, food intake, bullying behaviours, substance use, physical fight and attacks, suicide ideas, and injuries among adolescents in Mauritius [7–10]. Perhaps, such proactive interventions and policy implementation will help promote the physical and psychosocial health of adolescents in Mauritius.