{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:08:57Z","timestamp":1773878937670,"version":"3.50.1"},"reference-count":95,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosmentalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Ment Health"],"abstract":"<jats:p>Adolescents are especially vulnerable to stress and trauma. Exposure to armed conflict significantly raises the risk of anxiety, which often lasts into the post-conflict phase. The war in northern Ethiopia has caused widespread trauma, displacement, and destruction of services. Understanding mental health after conflict is crucial for guiding recovery efforts, informing school-based programs, and shaping local public health priorities. However, data on the prevalence of post-war anxiety among secondary school students in the region is lacking. This study assessed the prevalence and factors associated with clinically significant anxiety among secondary school students in Tigray, Ethiopia. A school-based cross-sectional study was conducted among 608 randomly selected secondary school students in Adigrat Town, Tigray, Ethiopia. Data was collected using a structured self-administered questionnaire, including the Generalized Anxiety Disorder (GAD)-7 scale for anxiety assessment. Multivariable binary logistic regression was used to identify factors associated with clinically significant anxiety symptoms. The prevalence of clinically significant anxiety symptoms among students was 32.7% (95% CI: 28.9%, 36.5%). Among sociodemographic factors, being female (AOR\u2009=\u20096.52, 95% CI: 3.70, 11.46) and age\u2009\u2265\u200918 years (AOR\u2009=\u20093.19, 95% CI: 1.60, 6.39) were significantly associated with anxiety symptoms. Trauma-related experiences, including combat or exposure to a battlefield (AOR\u2009=\u20095.05, 95% CI: 1.95, 13.12), physical violence (AOR\u2009=\u20092.25, 95% CI: 1.32, 3.82), bullying (AOR\u2009=\u20092.26, 95% CI: 1.24, 4.11), and contact sexual abuse (AOR\u2009=\u20093.97, 95% CI: 1.58, 9.96), were significantly associated with anxiety symptoms. Suicidal ideation (AOR\u2009=\u20094.01, 95% CI: 1.96, 8.24) and depression (AOR\u2009=\u20093.99, 95% CI: 2.32, 6.87) were also significantly associated with anxiety symptoms. This study reveals a high prevalence of clinically significant anxiety symptoms among secondary school students, associated with gender, age, trauma exposure, and comorbid conditions. These findings highlight the need for school-based mental health screening and trauma-informed support to reduce long-term psychological effects in this vulnerable generation.<\/jats:p>","DOI":"10.1371\/journal.pmen.0000526","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:33:01Z","timestamp":1773855181000},"page":"e0000526","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmen.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anxiety among secondary school students in the war-torn Tigray, Ethiopia, 2024: A call for action"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7530-6675","authenticated-orcid":true,"given":"Haftom Tesfay","family":"Gebremedhin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9945-0970","authenticated-orcid":true,"given":"Abadi Kidanemariam","family":"Berhe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8029-9492","authenticated-orcid":true,"given":"Yemane Gebremariam","family":"Gebre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2173-6685","authenticated-orcid":true,"given":"Alem","family":"Gebremariam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8003-5681","authenticated-orcid":true,"given":"Mulu Ftwi","family":"Beraki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4576-9684","authenticated-orcid":true,"given":"Tesfay 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