Alhassan Mohammed Abdulrahman, Alhasan Fatima
College of Medicine, Department of Pediatrics, Prince Sattam Bin Abdulaziz University. Al-Kharj, Kingdom of Saudi Arabia.
Faculty of Medicine, Department of Physiology, Gezira University. Wad-Madani, Sudan.
PLoS One. 2025 Apr 2;20(4):e0321289. doi: 10.1371/journal.pone.0321289. eCollection 2025.
To assess the growth and nutritional status of children in primary schools across different socioeconomic groups in Wad-Madani City, Central Sudan, and map it to World Health Organization (WHO) standards; and to investigate a potential association between school meal intake and nutritional status.
This cross-sectional anthropometric study involved a randomly selected sample of 506 children from 10 primary schools in the city. Height and weight were measured following WHO standards and converted into Z-scores for weight-for-age (WAZ), height-for-age (HAZ), and BMI-for-age (BAZ). We compared the mean Z-scores between children in the private and public school sectors, adjusting for ethnicity and other potential predictors. Statistical analyses included multivariate linear regression to assess predictors of growth and nutritional status, alongside group comparisons using appropriate statistical tests.
Children in public schools had significantly lower BAZ and HAZ levels compared to both WHO standards and private school children. The mean BAZ was -1.0 (SD = 1.23) for public school children and -0.13 (SD = 1.40) for private school children (p = 0.001), with 17.8% (n = 57) of public school children classified as thin (wasted) or severely wasted. The median HAZ was -0.20 (95% CI: -0.34, -0.02) for public school children and 0.19 (95% CI: 0.03, 0.40) for private school children (p < 0.001). Additionally, children in suburban public schools had a significantly lower mean HAZ (-0.46, SD = 11.33) compared to those in urban public schools (p = 0.009). Compared to WHO growth standards, public school children had significantly lower mean WAZ (p < 0.001), HAZ (p = 0.002), and BAZ (p < 0.001). Children who received school meals had significantly higher WAZ (mean difference = 0.619, p = 0.001), HAZ (mean difference = 0.401, p = 0.010), and BAZ (mean difference = 0.588, p = 0.003) across the entire sample. Even within the public-school subgroup, while statistical significance was not reached, all three parameters-WAZ (mean difference = 0.334, p = 0.074), HAZ (mean difference = 0.262, p = 0.123), and BAZ (mean difference = 0.299, p = 0.132)-remained consistently higher among those who received school meals.
Public school children exhibit unfavorable growth and nutritional status, which may be attributed to inadequate nutritional and calorie intake. School meals may improve nutritional outcomes. We propose urgent intervention through the provision of nutritionally adequate school meals.
评估苏丹中部瓦德迈达尼市不同社会经济群体的小学生的生长发育和营养状况，并将其与世界卫生组织（WHO）标准进行比对；调查学校膳食摄入量与营养状况之间的潜在关联。
这项横断面人体测量研究从该市10所小学中随机抽取了506名儿童作为样本。按照WHO标准测量身高和体重，并将其转换为年龄别体重（WAZ）、年龄别身高（HAZ）和年龄别体重指数（BAZ）的Z评分。我们比较了私立和公立学校儿童的平均Z评分，并对种族和其他潜在预测因素进行了校正。统计分析包括多元线性回归，以评估生长发育和营养状况的预测因素，同时使用适当的统计检验进行组间比较。
与WHO标准以及私立学校儿童相比，公立学校儿童的BAZ和HAZ水平显著更低。公立学校儿童的平均BAZ为-1.0（标准差=1.23），私立学校儿童为-0.13（标准差=1.40）（p=0.001），17.8%（n=57）的公立学校儿童被归类为消瘦（发育迟缓）或严重消瘦。公立学校儿童的HAZ中位数为-0.20（95%置信区间：-0.34，-0.02），私立学校儿童为0.19（95%置信区间：0.03，0.40）（p<0.001）。此外，郊区公立学校儿童的平均HAZ（-0.46，标准差=11.33）显著低于城市公立学校儿童（p=0.009）。与WHO生长标准相比，公立学校儿童的平均WAZ（p<0.001）、HAZ（p=0.002）和BAZ（p<0.001）显著更低。在整个样本中，接受学校膳食的儿童的WAZ（平均差异=0.619，p=0.001）、HAZ（平均差异=0.401，p=0.010）和BAZ（平均差异=0.588，p=0.003）显著更高。即使在公立学校亚组中，虽然未达到统计学显著性，但接受学校膳食的儿童的所有三个参数——WAZ（平均差异=0.334，p=0.074）、HAZ（平均差异=0.262，p=0.123）和BAZ（平均差异=0.299，p=0.132）——仍然始终更高。
公立学校儿童表现出不良的生长发育和营养状况，这可能归因于营养和热量摄入不足。学校膳食可能改善营养结果。我们建议通过提供营养充足的学校膳食进行紧急干预。
