Scanning for Obesogenicity of Primary School Environments in Tshwane, Gauteng, South Africa

The purpose of this study was to scan for the obesogenicity of primary school environments in Tshwane, Gauteng, South Africa. This study was carried out in ten public primary schools in the Tshwane West district of the Gauteng province. An observational design was used to collect the data. Data collection was conducted using an observational checklist guided by the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The findings revealed that although a nutrition policy was available in most schools, few schools were communicating the policy. Despite all the schools having sports fields, children were not exercising. Most schools also had a school nutrition programme. Most primary schoolchildren's lunchboxes contained sweets, sugar-sweetened beverages, and snacks. A few lunchboxes contained fruits and vegetables. Primary schools in Tshwane West did not comply with most aspects of the school mapping environment, indicating that the school environments were obesogenic. It is therefore essential to scan for obesogenicity in all South African schools so that tailor-made interventions can be implemented to rectify and further prevent obesogenic school environments.

Prevalence of Skin Disease and Its Associated Factors Among Primary Schoolchildren: A Cross-Sectional Study from a Northern Ethiopian Town

Background

Skin disease affects people of all ages, yet children are one of the most common victims of it. Although some data indicate a high prevalence of skin disorders among Ethiopian primary schoolchildren, little is known regarding it, particularly in the study area. Hence, the study aimed to investigate the prevalence of skin disease and its associated factors among primary schoolchildren in Debre Berhan town, North Shoa, Ethiopia.

Methods

Institutional-based cross-sectional study was conducted. The samples were chosen using a multistage stratified random sampling technique. Data were collected using both a self-administered and an interviewer-administered questionnaire. Children were clinically examined to detect and record the dermatological findings. A potassium hydroxide test was used to confirm some doubtful cases. The data were entered in Epi Info version 3.5.1 and analyzed using SPSS version 20.0. Variables with a p-value <0.05 were designated as having statistical significance.

Results

The overall point prevalence of any skin disease was 61.2% (95% CI: 56.4–66.1). In a multivariable logistic regression model, a significant association between skin diseases and the occupation of the father being a farmer (AOR: 4.21, 95% CI: 1.06–16.63), bad personal hygiene (AOR: 1.78, 95% CI: 1.03–4.38), previous history of skin disease (AOR: 2.74, 95% CI: 1.41–5.30), exchange of clothes and towels with other family members (AOR: 1.50, 95% CI: 1.09–2.85), presence of trauma in the last one month (AOR: 2.09, 95% CI: 1.18–3.72) and not being a member of health insurance (AOR: 1.95, 95% CI: 1.16–3.28) has been found.

Conclusion

The point prevalence of any skin disorder is alarmingly high. The commonest disorders found in this study were simple and could usually be cured easily. Hence, preventive and curative health services should be provided for these schoolchildren to achieve a considerable reduction in the prevalence of skin disorders.

Physical Activity, Cardiorespiratory Fitness and Clustered Cardiovascular Risk in South African Primary Schoolchildren from Disadvantaged Communities: A Cross-Sectional Study

The coexistence of multiple cardiovascular risk factors has been reported in school-aged children from the age of nine years, but most evidence stems from high-income countries. This cross-sectional study aimed at describing the cardiovascular health risk, physical activity (PA) behavior and cardiorespiratory fitness (CRF) levels of South African primary schoolchildren, and at examining the associations between PA/CRF and a composite measure of cardiovascular risk. Cross-sectional data from 832 primary schoolchildren (grade 1–4) were analyzed. Total cholesterol/HDL ratio, triglycerides, systolic/diastolic blood pressure, body fat, and glycated hemoglobin were assessed as cardiovascular risk markers. Data were analyzed via mixed linear regressions and analyses of covariance. Overall, 24.2% of the participants did not meet current PA standards. Higher CRF/PA were associated with lower body fat and lower clustered cardiovascular risk (p < 0.05). When categorizing children into CRF/PA quartiles, a lower clustered cardiovascular risk gradient was found in children with higher CRF (p < 0.05) or PA (p < 0.05). Our data shows that higher CRF/PA is associated with lower clustered cardiovascular risk already from a young age. Given that clustered cardiovascular risk present during childhood can track into adulthood, we advocate for PA participation and a healthy weight from a young age onwards.

A Study Protocol to Determine Heat-Related Health Impacts among Primary Schoolchildren in South Africa

Climate models predict that the global average temperature of Earth will rise in the future. Studies show that high classroom temperatures can affect the ability of the student to learn and function. It is important to understand the impact that heat will have on the health, wellbeing, and academic performance of learners, as they spend a significant amount of time in classrooms compared to any other environment. A follow-up panel study among 20 public primary schools in the Gauteng province (South Africa) will be carried out, in which Grade 4 learners will be selected to complete an hourly heat-health symptom questionnaire. A Cambridge Neuropsychological Test Automated Battery (CANTAB) test will be used to determine their memory and attention span. A nursing practitioner will measure body weight, height, and temperature. Lascar data loggers will be used to measure indoor classroom temperature. School principals will complete a questionnaire on existing school coping mechanisms and policies in place that help deal with hot weather conditions. This is the first study to quantitatively assess the effects of heat on learners' health, well-being and school performance in South Africa. The outcomes of this study will enable policymakers and public officials to develop appropriate school heat adaptation and mitigation measures and will assist in channeling their resources where it is most needed.

Welsh Primary Schoolchildren's Perceptions of Electronic Cigarettes: A Mixed Methods Study

There are concerns that the growing popularity of e-cigarettes promotes experimentation among children. Given the influence of the early years on attitude and habit formation, better understanding of how younger children perceive vaping before experimentation begins is needed, to prevent uptake and inform tobacco control strategies. We explored Welsh primary schoolchildren’s (aged 7–11) awareness of e-cigarettes relative to tobacco smoking, their understanding of the perceived risks and benefits and their intentions and beliefs about vaping. Data was collected using a mix of methods in June and July 2017 from 8 purposively selected primary schools across Wales. Four hundred and ninety-five children (52% female) aged 7 years (n = 165), 9 years (n = 185) and 11 years (n = 145) completed a class-administered booklet encompassing a draw and write exercise and survey. Ninety-six children participated in 24 peer discussion groups comprised of 2 boys and 2 girls from each year group. Data were analysed independently and findings triangulated. Survey analyses used frequencies, descriptive statistics and chi-squared tests. Content analysis was undertaken on the draw and write data and peer discussion groups were analysed thematically. Study findings highlight that primary schoolchildren have general awareness of e-cigarettes. Vaping was perceived to be healthier than smoking and there was some recognition that e-cigarettes were used for smoking cessation. Understanding of any health harms was limited. Few children intended to smoke or vape in the future but almost half thought it was okay for grownups. Children’s perceptions were influenced by exposure through family and friends. Findings suggest a need for e-cigarette education in primary schools, to highlight the associated risks of e-cigarette experimentation including the potential for tobacco initiation.

Physical fitness and nutritional anthropometric status of children from disadvantaged communities in the Nelson Mandela Bay region

Background

Information about the relationships between physical fitness, body composition and nutrition has increased in recent years; however, little is known about physical fitness and the coexistence of under-/overnutrition among children living in disadvantaged areas.

Objectives

To determine the physical fitness status and its association with body composition, growth and selected socio-demographics in primary schoolchildren from disadvantaged communities in the Nelson Mandela Bay region.

Methods

Nine hundred and sixty-five children (49% girls, M=9.5 years) participated in this cross-sectional study. Height and weight were measured to establish body mass index, and height-for-age z-scores. Physical fitness was assessed using tests from the Eurofit Physical Fitness test battery (flexibility, upper/lower body muscular strength and cardiorespiratory fitness). Between-group differences and cross-sectional associations were examined with univariate (Chi²-tests, analyses of variance) and multivariate methods (mixed linear/logistic regression).

Results

Most children had normal weight (76.7%), while 4.5% were underweight and 18.7% were overweight/obese. Underweight children and children with stunted growth (11.5%) had lower average upper body strength (p<0.001). Overweight/obese children had lower scores in weight-bearing activities (p<0.001). Children with higher socio-economic status were more likely to be overweight and obese (p<0.001). In the multivariate analyses, sex, age, body mass index, and stunting were associated with children's physical fitness.

Conclusion

Fitness assessments seem to be a relevant measure of the current health status of children in disadvantaged settings. Compared to international norms, the children in this study had relatively low scores for both upper- and lower body muscular strength. Therefore, effective school-based intervention programmes should be developed to improve children's physical fitness in disadvantaged schools.

[Assessment of physical development and diet of primary school children in Smolensk]

The growth and development of children largely depends on the diet. Irrational and irregular nutrition can contribute to the development of nutritional-dependent diseases of children and adolescents, the formation of overweight and obesity. The aim of the research - the assessment of physical development and diet of primary schoolchildren living in Smolensk. Material and methods. 817 schoolchildren aged 7-10 have been surveyed, of whom 403 (49.3%) were girls and 414 (50.7%) were boys. In the process of the study, the length and body mass have been measured, body mass index (BMI) has been calculated. Assessment of the physical development of children has been carried out according to the standards of the World Health Organization (WHO) using the software product WHO AnthroPlus (2009). Z-score values for body weight for age, body length for age, and BMI for age have been calculated. In the process of the study, children were questioned. A questionnaire on the diagnosis of the lifestyle of children, developed by specialists from the University of Cologne, made it possible to evaluate the mode and structure of nutrition of schoolchildren. Results and discussion. It has been revealed that the average values of mass-growth indicators of Smolensk primary schoolchildren were higher compared with the standard WHO population. Deviations of physical development in the studied sample of schoolchildren were more concerned with body weight than growth, while obesity in boys was detected significantly more often than in girls (11.9 vs 5.2%, χ²=10.465, p=0.002). It has been established that the majority of primary schoolchildren (84.8%) ate 3-5 times a day. 92.7% of schoolchildren have breakfast at home. In the school canteen, only 55.6% of schoolchildren ate regularly. In the interval between dinner and supper, the majority (96.8%) of the respondents had a snack, of which 43.7% used patties, cookies or sweets for snacking. Almost half of primary schoolchildren (45.4%) admitted that they had food intake just before bedtime. Moreover, boys did this significantly more often than girls (50.8 vs 41.0%, χ²=5.209, p=0.023). Conclusion. In order to prevent the formation of overweight and obesity among primary schoolchildren, it is necessary to introduce a complex of preventive measures. Among them, there are rationalization of children's nutrition in the family and school, optimization of the day regime and physical activity of children, psychological support for children with overweight and obesity, the introduction of modern educational and information technologies for the formation of a healthy lifestyle of children.

Food and nutrition literacy (FNLIT) and its predictors in primary schoolchildren in Iran

This study used a locally designed and validated questionnaire to describe the distribution of food and nutrition literacy (FNLIT) in a cross-sectional sample of 803 students aged 10-12 years from elementary schools in Tehran city, Iran. Logistic regression was used to assess the extent to which various independent covariates were associated with low FNLIT. The data were used to identify significant differences using a range of social and cultural variables relevant to the context of school students in Iran. The results of the study showed that although the total FNLIT level was good, this headline finding masked important differences in the sub-domains. More than half of the children (69%) had high levels of FNLIT in the cognitive domain, but in the skills domain, very few (3%) scored highly. The study also identified some associations between the total FNLIT and its subscales and sociodemographic variables including gender, parent's education and age, birth order. These results highlighted groups within the school population who were at higher risk of having lower FNLIT levels. They also indicate that girls feel more able to exert choice and control over food and nutrition decisions than boys are but may be less able to do so in practice. Overall, these results are a general reminder to schools of the different learning needs of children from different family backgrounds. The article highlights the need for continuous improvement in the health education curriculum of schools in Iran, particularly highlighting the importance of giving greater attention to the development of practical food and nutrition skills alongside more traditional food and nutrition knowledge. Additional studies (with long-term follow-up) are needed to more fully assess and understand the predictors of FNLIT.

School-Based Preventive Dental Program in Rural Communities of the Republic of Armenia

Objectives: This paper describes a school-based preventive dental program implemented in 14 rural schools within nine villages of Armenia. As part of the program, school-based toothbrushing stations (called Brushadromes) were installed in the participating schools. The intervention included school-based supervised toothbrushing with fluoride toothpaste and oral hygiene education.

Methods: The study evaluates the prevalence and levels of dental caries among rural schoolchildren in 2013 (before the implementation of the preventive program, referred to as a pre-intervention group) and 2017 (4 years after the start of the program, referred to as an intervention group) in two randomly selected villages where the program was implemented. A repeated cross-sectional study design was used. The prevalence of caries and the number of decayed, missing, and filled teeth in permanent dentition (DMFT) and primary dentition (dmft) were recorded among 6–7 and 10–11-year-old schoolchildren in 2013 (n = 166) and 2017 (n = 148). The pre-intervention and intervention groups include different children in the same age range, from the same villages, examined at different time points. In both instances, they represented over 95% of the 6–7 and 10–11-year-old student populations of the studied villages. Pearson Chi-square, Fisher's Exact test, independent t-test, and quasi-likelihood Poisson regression were utilized for data analysis.

Results: Schoolchildren involved in the intervention had significantly less decay levels compared to same-age pre-intervention groups. For 10–11-year-old schoolchildren involved in the program, the mean number of permanent teeth with caries was lower by a factor of 0.689 (lower by 31.1%), p = 0.008, 95% CI, 0.523; 0.902, compared to the 10–11-year-old pre-intervention group, after controlling for age, sex, child's socio-economic vulnerability status, the village of residence, and the number of permanent teeth with fillings.

Conclusions: The study indicates a significantly lower level of caries among schoolchildren in the studied two villages where the intervention was implemented. The described intervention is particularly suitable in rural settings where water fluoridation is not available and homes have limited availability of running water.

Investigating Motor Competence in Association with Sedentary Behavior and Physical Activity in 7- to 11-Year-Old Children

Children's motor competence (MC) has declined in the past decades, while sedentary behavior (SB) has increased. This study examined the association between MC and physical activity (PA) levels among primary schoolchildren. Demographics, body height and weight, MC (Athletic Skills Track), and PA levels (ActiGraph, GT3X+) were assessed among 595 children (291 boys, mean age = 9.1 years, SD = 1.1). MC was standardized into five categories: from very low to very high. PA levels were classified into SB, light PA (LPA), and moderate-to-vigorous PA (MVPA). Mixed-model analyses were conducted with PA levels as dependent variables and MC as the independent variable, while adjusting for age, gender, and body mass index (BMI) z-score on the individual level. A negative association between MC and SB and a positive association between MC and MVPA were found. The strength of both associations increased as children expressed lower or higher levels of MC. MC is an important correlate of both SB and MVPA, particularly for children with very high or low MC. Developing and improving children's MC may contribute to spending less time in SB and more time in MVPA, particularly for high-risk groups, i.e., children with low MC. Moreover, addressing MC development and PA promotion simultaneously might create positive feedback loops for both children's MC and PA levels.

The prevalence of malnutrition based on anthropometry among primary schoolchildren in Binh Dinh province, Vietnam in 2016

Objective

The study was conducted to determine the prevalence of malnutrition based on anthropometry among primary schoolchildren in Binh Dinh province, Vietnam.

Material and Methods

This was a school-based cross-sectional survey using random sample technique with multistage process. Variables in malnutrition were classifed as thinness, stunting, underweight, overweight, and obesity based on z-scores according to the World Health Organization (WHO) (2007). Anthropometric measurements were taken according to WHO's standard procedures. The Chi-square test was used to compare prevalences and the Chi-square test for trend was employed to assess the trend of the prevalence of malnutrition forms by age.

Results

6,514 pupils from 6 to 10 years old including 3,298 males and 3,216 females were observed. The prevalence of thinness, stunting, underweight, overweight and obesity among schoolchildren accounted for 11.19%, 6.16%, 10.79%, and 30.1%, respectively. The prevalence of underweight and that of overweight-obesity of all pupils at the age of 6 were 13.1% and 32.11%, respectively, and tended to decrease to age 10 (p < 0.01). The prevalence of thin and stunted pupils had little sign of change over ages (p > 0.05). There was a statistically significant difference in the prevalence of malnutrition in three areas of Binh Dinh (p < 0.05), in which the highest prevalence of undernutrition was in mountainous area and midland, and the highest prevalence of overweight-obesity was in urban areas.

Conclusion

The prevalence of malnutrition of primary schoolchildren in Binh Dinh was relatively high, in which the prevalence of overweight-obesity was rather high in urban areas and the prevalence of undernutrition was pretty high in mountainous area and midland. This study has characterized an important public health challenge, highlighting the need for attention to potential interventions.

Associations Among Food Insecurity, Academic Performance, and Weight Status in Primary Schoolchildren in Tehran, Iran: A Cross-sectional Study

OBJECTIVE

To examine the associations among household food insecurity (FI), academic performance, and weight status in urban primary schoolchildren.

DESIGN

Cross-sectional study.

SETTING

Primary schools in Tehran, Iran.

PARTICIPANTS

A total of 803 students (419 boys and 384 girls), aged 10-12 years, were recruited from 43 primary schools.

MAIN OUTCOME MEASURES

Levels of FI were measured using a locally validated, 18-item household food security survey module. Academic performance was assessed by 152 teachers through a specifically designed, 20-scale questionnaire. Standard anthropometric measurements were also taken.

ANALYSIS

Linear and multinomial regressions were conducted.

RESULTS

At the household level, FI was associated with poorer grades in all subjects studied (except for social science in FI without hunger) (P < .05). At the child level, a significant association was observed between low food security and poorer grades in all subjects studied, whereas for very low food security, this relationship was significant only for mathematics, reading, and science (P < .05). Food insecurity without hunger (odds ratio = 2.56; 95% confidence interval, 1.05-6.23) and low food security (odds ratio = 4.41; 95% confidence interval, 1.58-12.23) were associated with overweight only in girls.

CONCLUSIONS AND IMPLICATIONS

The findings confirm the need for policies and programs to improve students' dietary quality and food security to improve their health as well as educational attainment. Future research is needed to explore further the association between food security and academic performance.

Head Lice among Governmental Primary School Students in Southern Jordan: Prevalence and Risk Factors

Background:

Head lice, a common social and health problem among all age groups, is especially widespread among school-aged children.

Aims:

This study aimed to assess the prevalence of pediculosis capitis among governmental primary school students in Southern Jordan and its related risk factors.

Settings and Design:

A sample of 500 primary schools students aged 6–12 from two male and two female public primary schools in four educational directorates were selected randomly in this cross-sectional study.

Materials and Methods:

Data were collected using a modified questionnaire that was completed by the students with the help of their parents. Students were then asked to return the questionnaire a day ahead of the examination date with a signed consent from the parents.

Statistical Analysis:

SPSS software was used with Chi-square testing to study the significant relationship between lice infestation prevalence and the independent variables. Statistical significance was set at P < 0.05.

Results and Conclusion:

The overall prevalence of lice infestation was 20.4% and was significantly higher among girls than boys. The prevalence rate was higher among rural residents, those living in shared rooms, families with a monthly income of <200 Jordanian Dinar, illiterate father and mother, those living in families with more than five members, houses with fewer than three rooms, students with longer hair, those with a history of infestation in the previous year, and students who share home articles with other family members. Female gender, low socioeconomic status, a history of contact, inadequate hygiene practices, and sharing articles were the major risk factors.

Prevalence of general binocular dysfunctions among rural schoolchildren in South Korea

BACKGROUND/PURPOSE

To assess the prevalence of nonstrabismic accommodative and vergence dysfunctions among primary schoolchildren in Hampyeong, a rural area of South Korea.

METHODS

Five hundred and eighty-nine primary schoolchildren, 8-13 years old, were each given a thorough eye examination, including binocular-vision testing, near point of convergence, horizontal phoria measurement by von Graefe, and negative and positive vergence amplitudes with prism bar, to determine any form of accommodative or vergence dysfunctions.

RESULTS

Of the 589 participants examined, 168 (28.5%) primary schoolchildren presented some form of nonstrabismic accommodative or vergence dysfunctions. The prevalence of accommodative dysfunctions and vergence dysfunctions was 13.2% and 9%, respectively. Convergence insufficiency (10.3%) was more prevalent than convergence excess (1.9%), and accommodative insufficiency (5.3%) was more prevalent than accommodative excess (1.2%).

CONCLUSION

This study suggests that nonstrabismic accommodative and vergence dysfunctions are prevalent in the rural area of South Korean primary schoolchildren, and convergence insufficiency was the most prevalent.

Revised Healthy Lifestyle-Diet Index and associations with obesity and iron deficiency in schoolchildren: The Healthy Growth Study

BACKGROUND

The Healthy Lifestyle-Diet Index (HLD-index), previously developed to assess the degree of adherence to dietary and lifestyle guidelines for primary schoolchildren, was revised according to updated recommendations. Τhe association of the revised HLD-index (R-HLD-index) with obesity and iron deficiency (ID) was also examined.

METHODS

A representative sample of 2660 primary schoolchildren from Greece (9-13 years old) participating in the 'Healthy Growth Study' was examined. Twelve components related to dietary and lifestyle patterns were used to develop the R-HLD-index. Scores from 0 up to 4 were assigned to each one of these components, giving a total score ranging from 0 to 48. The associations between the R-HLD-index, obesity and ID were examined via logistic regression analysis.

RESULTS

The total score of the R-HLD-index calculated for each one of the study participants was found to range between 2 and 32 units, with higher scores being indicative of a healthier lifestyle and better diet quality. After adjusting for potential confounders, logistic regression analysis showed that an increase in the R-HLD-index score by one unit was associated with 6% lower odds for obesity. However, no significant association was observed between the R-HLD-index score and ID.

CONCLUSIONS

The R-HLD-index may be a useful tool for public health policy makers and healthcare professionals when assessing diet quality and lifestyle patterns of primary schoolchildren. Identification of children with lower scores in the R-HLD-index and its individual components could guide tailored made interventions targeting specific children and behaviors.