Children in low- and middle-income countries are disproportionately affected by socioeconomic disparities, which might influence access to diverse and nutritious foods, increasing the risk of food insecurity and low dietary quality. Hence, monitoring of these conditions is crucial. This study examined whether children from households with different wealth status vary concerning food insecurity, dietary diversity, consumption of specific food groups, and risk of stunting. Baseline data were utilized from a multi-country randomized intervention trial. Primary school children (Mage= 8.3±1.4 years; 416 girls and 423 boys) from four schools in a marginalized, peri-urban area (government-defined wealth index quintile 3) in Gqeberha, South Africa, participated. Parents/guardians provided information about household socioeconomic factors and completed a 24-hour food item checklist and a food security questionnaire. Stunted children were defined as <-2 SD height-for-age compared to current World Health Organization child growth standards. Analyses of variance and χ2-tests were employed to compare children classified into five wealth quintiles. On average, children consumed food items from 5.8±2.0 healthy food groups. One out of 12 children (8.4

Early activity and eating patterns can lead to obesity and determine patterns later in life. Research on activity and food parenting practices for young children is scarce. The aim of this article is to describe the knowledge and practices that may lead to obesity in mothers and children under the age of five at seven public health centres in the Eastern Cape. A quantitative study with a convenience sample of 142 mothers was used. Fieldworkers assisted mothers in completing a questionnaire. Excel (2016) and SPSS version 28.0 were used for descriptive statistics, and Pearson Chi-square tests determined associations. From the results, none of the mothers met the recommendations for daily moderate activity; only 14.7% of the children were moderately active, while 32% demonstrated excessive television time. Food is most often boiled (83.8%) with salt added (54.9%). Sweet snacks (34.4%), sugar-sweetened beverages (31.6%) and savoury snacks (44.4%) were consumed often. Fruit and vegetables were eaten once or more daily by only 49.3% and 13.4% of the children, respectively. Emphasis on preparing food at home and eating fruit and vegetables in educational programmes is encouraged. This can assist mothers in gaining the correct knowledge and skills, to prevent obesity in children and later in life.

Abstract Background: The global prevalence of malnutrition is high, with obesity rates being 10% while South Africa exceeds this with an obesity rate of 13.5% in schoolchildren. There is a need for a simple, quick, reliable method for screening for underweight, overweight and obesity in children at the primary healthcare level, allowing for quicker, easier, and more accurate identification and better screening and referral for appropriate treatment. Aim: The aim of this study was to determine the suitability of neck circumference, compared to the body mass index (BMI) and mid-upper-arm circumference (MUAC), in measuring malnutrition in primary school children in Gqeberha, South Africa. The suitability of the international neck circumference cut-off values, currently available, in measuring malnutrition was also evaluated. Methods: In this descriptive, cross-sectional study, anthropometrical and demographical data was obtained, including weight, height (to determine BMI), MUAC and neck circumference, from 493 children. The classification of BMI and MUAC was compared to the participants’ neck circumference classification to determine whether neck circumference is a suitable method for screening for under- or overweight and obesity. Results: While 4.06% of the children were underweight, 86.21% had a normal weight, and 9.74% of the children were overweight or obese according to the World Health Organization’s BMI for age classification (gold standard). Against this standard, neck circumference cut-off values had a sensitivity and specificity of 56.25% and 61.57% respectively. In females, there was a significant association with BMI-for-age (X2(8) = 23.545, p = 0.003, Cramer’s V = 0.202) and for males it was also significant (X2(4) = 17.192, p = 0.002, Cramer’s V = 0.290). However, according to the ROC curves, there was less specificity for males. Discussion and conclusion: A key observation was the variation in overweight and obesity prevalence, depending on which neck circumference cut-off reference was applied. This inconsistency highlights the potential risks of using international reference values without validating them in local populations. The moderate sensitivity and specificity observed suggest that while neck circumference shows promise as a screening method, existing cut-off values may not be optimal for a South African child population. Key words: Body mass index, Neck circumference, Obesity, Overweight, Primary school children.

Non-communicable diseases (NCDs) account for most of global deaths, with rising prevalence in low-and middle-income countries. Metabolic syndrome (MetS) is a cluster of interrelated NCD risk factors, including obesity, dyslipidaemia, hypertension, and hyperglycaemia, that amplify NCD risk. Four leading modifiable factors driving NCDs are physical inactivity, tobacco and alcohol use, and an unhealthy diet. Teachers in under-resourced schools face significant health challenges, with their wellbeing often overlooked in South Africa. The prevalence and severity of MetS, adherence to physical activity guidelines, and associations with modifiable NCD risk factors were assessed. This study, part of the ‘ KaziBantu : Healthy Schools for Healthy Communities’ project, included 168 teachers (aged 21–72, mean = 47 years) from 8 under-resourced schools in Gqeberha, South Africa. Data collection included MetS markers, device-measured physical activity, tobacco and alcohol use, and total fat, saturated fat, sugar, and sodium intake. Covariates included age, sex, race, education, and household income. MetS was observed in 58% of participants, with central obesity (79%) being the most prevalent component, followed by hypertension (59%). The largest proportion of participants (26%) had 3 MetS components, followed by 4 components (20%), while 12% had all 5 components. Nearly half (44%) of teachers were physically inactive and 53% exceeded total fat intake recommendations. Bayesian multilevel logistic regression revealed key predictors of MetS: age (per year increase; odds ratio[OR]=1.15, 95% credible interval[CrI] [1.07, 1.24]) and high daily total fat intake (OR=3.37, 95%CrI [1.03, 11.96]) were positively associated, while hours spent in moderate-to-vigorous intensity physical activity per week (OR=0.73, 95%CrI [0.55, 0.95]) and higher monthly household income (OR=0.14, 95%CrI [0.02, 0.72]) were protective. Addressing physical inactivity and unhealthy diets through tailored interventions is crucial to reducing MetS prevalence and improving the health of teachers working in low-resourced settings. Effective solutions should empower healthier lifestyles while tackling structural barriers to health equity.

The appropriate and adequate feeding practices by mothers are important determinants in ensuring optimal health and well-being during infancy and early childhood. However, some mothers who visit public health clinics have minimal knowledge of breast- and complementary feeding. This study aimed to determine the knowledge, attitudes and practices of mothers regarding breastfeeding and weaning. A purposefully selected sample of 200 mothers with children below two years of age in the Colesberg district, Northern Cape, participated. After consent, a questionnaire on infant and early childhood feeding was completed with the assistance of a fieldworker. Anthropometrical measurements were conducted on the children, followed by a 24-hour dietary recall. The nutritional status of the children was analysed utilising the WHO Anthro Survey Analyser Tool. Microsoft Excel and IBM Social Sciences Statistics Data Editor Version 24 were used for analysis. Together with literature on infant and early childhood feeding from the WHO (2021) and the Road to Health Booklet (2018), this data was utilised to compile an intervention key ring. The findings indicated that mothers have good knowledge regarding infant feeding; however, their incorrect feeding practices do not reflect this. Significant associations between mothers' practices and the nutritional status of their children were found. Qualitative research, such as focus groups, is necessary to investigate the possible challenges and explain why mothers are not practising their knowledge obtained regarding infant feeding.

Childhood stunting is the most prevalent form of chronic malnutrition, affecting 149 million children under the age of five worldwide. As the determinants of stunting are complex and multicausal, it is important to look at area specific determinants and determine whether these are similar to the general determinants. This study investigated the prevalence and determinants of stunting in children under the age of five, visiting Bisho Hospital clinic in the Eastern Cape, South Africa. A cross-sectional, qualitative design was used. All children under the age of five, visiting Bisho Hospital’s clinic during the data collection period, and whose mothers provided consent, were included in the sample of 219 participants. An interview-administered questionnaire was used to determine possible factors that may play a role in stunting. Anthropometrical measurements (height, weight and mid-upper arm circumference) were used to calculate z-scores for the children. IBM SPSS Statistics 26 (version 24.0) was used for statistical analysis. Dietary diversity was calculated with a seven food group classification. The prevalence of stunting was 47.5 %, of which 57.7 % were classified as moderately stunted, and 42.3 % severely stunted. There was a significant correlation between the participants’ main form of sanitation and stunting in all age groups (p = 0.007; Cramer’s V = 0.413 and p = 0.04; Cramer’s V = 0.326, respectively). A statistical significance was found between the child support grant and stunting (p = 0.032) in children younger than six months, but not in the older group. No statistical significance was found between other determinants of stunting that were analysed. As stunting is multi-causal, it requires a combination of nutrition-specific and nutrition-sensitive interventions, together with strong political and financial commitment from stakeholders to eradicate stunting in children. Keywords: Stunting, Children, Sanitation, Infections, Breastfeeding

The unprecedented COVID-19 era was one that posed drastic changes and challenges to healthcare professionals and the healthcare system at large. During disastrous events such as the COVID-19 pandemic, psychosocial stress was expected in healthcare professionals along with the development of different coping mechanisms. The increased pressure and expectation from the healthcare system and the public, to ensure the continuation of care for patients while, ensuring that they themselves do not become patients, further increase stress and adversely affect mental and physical health. This can lead to decreasing performance and efficacy at work. Healthy dietary habits and physical activity are known to play significant roles in supporting mental health and the immune system by improving its response to infections. Therefore, it is important to ensure preparedness and improve wellness among these individuals in the event of future pandemics. The objectives of this quantitative, descriptive study were to determine the perceived changes of dietary and lifestyle habits in a sample of 348 healthcare professional during the COVID-19 pandemic and to investigate how environmental, physical, and social factors had contributed to the perceived diet and lifestyle changes. The findings indicated that healthcare professionals’ dietary habits and lifestyle were negatively affected by the COVID-19 pandemic. In total, 38% (n=131) had indicated that their weight had increased, they consumed more alcohol and fast foods and participated in less exercise. There was a high caffeine consumption and decreased sleep which could adversely affect healthcare professionals’ productivity, resilience and mental health. The negative impacts posed by the pandemic still needs to be mitigated as it has the potential to increase the burden of non-communicable diseases and cause even more burden to the healthcare system. Authorities need to coordinate and develop sustainable programmes relating to coping mechanisms during any state of disaster and support wellness initiatives. Dietitians should be involved in the continued coordination and promote healthy eating through regular training and education of other healthcare professional. Key words: Healthcare professionals, lifestyle, diet, COVID-19, Nutrition.

Objective: This study aimed to assess the objective understanding of five front-of-pack label formats, namely the Reference Intake, Multiple Traffic Light label, Nutri-Score, health endorsement logo and warning label, among consumers in Nelson Mandela Bay, South Africa. Design: This was a cross-sectional, exploratory study. Setting: Interviewer-administered surveys were conducted at 12 randomly selected food retail outlets in an urban setting. Subjects: A total of 359 adult participants were included in this study. Outcome measures: Objective understanding was measured by asking participants to rank food products according to their nutritional quality, using the displayed front-of-pack label. Results: The type of front-of-pack label significantly influenced ranking ability (p < 0.00001). All the evaluative front-of-pack labels significantly improved the participants’ ability to identify healthier food products compared with the no-label control. The reductive Reference Intake, however, showed no significant impact on consumer understanding. Conclusion: Evaluative front-of-pack labels significantly improved the participants’ ability to identify healthier food products, when compared with the Reference Intake and no-label control. Future research should test the objective understanding of culturally diverse groups in South Africa, particularly among rural populations.

Executive functions (EFs) are essential for optimal academic development. Appropriate nutrition and physical activity (PA) have been shown to facilitate optimal cognitive development. Therefore, this study examined whether a 12-week school-based PA and multi-micronutrient supplementation (MMNS) intervention would improve cognitive and academic performance. A cluster-randomized controlled trial (RCT) was conducted. Children from four schools located in a peri-urban area of South Africa were randomly assigned to (i) PA + MMNS, (ii) PA + placebo, (iii) MMNS or (iv) placebo. Information processing and inhibitory control were measured with a computerized Flanker task. End-of-year results provided insight into academic achievement. Anthropometric measures were used to determine nutritional status. Data were analyzed with linear mixed-models, adjusting for baseline scores, school classes and age; 932 children (458 girls (49.1%), Mage (mean age) = 8.42 ± 1.94 years) completed baseline and post-intervention assessments. Cognitive performance improved among all four groups, with no significant group × time effects. For academic achievement, there was no significant interaction effect between the combined intervention group and placebo. We encourage future studies in this neglected area in order to determine the most optimal design of school-based nutrition and PA programs to enhance overall cognitive performance.

Childhood stunting can have negative long-term consequences on cognitive development, academic achievement, and economic productivity later in life. We determined the prevalence of stunting and examined whether stunting and associated risk factors (low dietary diversity, insufficient hemoglobin, food insecurity, and soil-transmitted helminth (STH) infections) are associated with academic achievement and cognitive function among South African children living in marginalized communities. A cross-sectional sample of 1277 children (aged 5–12 years) was analyzed. Stunting was defined according to 2007 WHO growth references. Cognitive functioning was measured with the computerized Flanker task and academic performance via school grades. Blood and stool samples were collected to obtain hemoglobin level and STH infection. Dietary diversity was assessed by a food frequency questionnaire. Associations were examined via mixed linear regression (with school class as a random intercept). Nine percent of the children were stunted (95% CI: 7.6–10.8%). Low dietary diversity (β = 0.13, p = 0.004), food insecurity (β = −0.12, p = 0.034), and stunting (β = −0.13, p = 0.031) were associated with poorer end of the year results among girls. No such associations were found among boys. No significant associations were found for socioeconomic status and hemoglobin levels. The prevalence of stunting and STH infections were low in the present sample. Risk factors seem differently associated with girls’ and boys’ academic achievement. Promoting nutrition may help to promote academic achievement among girls living in low- and middle-income countries.

Front-of-pack food labels help consumers to make healthier food purchases and are thus an important tool for improving public health. Consumers’ label preferences directly influence their motivation regarding the use of front-of-pack labels. However, to date no consensus has been reached globally, or in South Africa, on which front-of-pack label format is the most effective at guiding healthier food choices. This study compared the perceptions of five front-of-pack labels formats among consumers in Nelson Mandela Bay.In this cross-sectional exploratory study with 359 participants, an interviewer-administered survey was conducted at twelve randomly selected retail food locations. The perceptions of five front-of- pack label formats (Reference Intake, Multiple Traffic Light label, Nutri-Score, health endorsement logo and warning labels) were assessed during the survey procedure.The health endorsement logo achieved the highest number of positive responses (n = 833), closely followed by the Nutri-Score (n = 813), while the Reference Intake received the highest number of negative responses (n = 437). Overall, both the health endorsement logo and Nutri-Score were positively perceived in terms of likeability and comprehensibility. The Multiple Traffic Light label was perceived to be trustworthy (38.7%, n = 139) and useful in terms of providing the necessary nutritional information (39.4%, n = 141). Participants identified the Reference Intake format as being difficult to understand (41.5%, n = 149). Overall, the results of this study point to participants preferring evaluative front-of-pack labels that make use of interpretative colours, symbols and text.

Background: There are few prehospital emergency medical care (PEMC) workers in South Africa and the work environment is demanding, with irregular and long hours. The situation can result in elevated stress levels (especially among younger people) and risky lifestyle behaviour, which can lead to non-communicable diseases. Aim: This article reports on a pilot study that explored factors that influence lifestyle risk behaviour among PEMC workers, with a specific focus on dietary habits that may, in turn, have an influence on work performance. Methods: An explorative, cross-sectional mixed-method pilot study was conducted. Focus groups, a lifestyle risk behaviour questionnaire and three 24-hour recalls for each participant were used as a convenience sample of 20 PEMC workers in a large South African city. Results: Irregular shifts, financial constraints, smoking and the unavailability of healthy food emerged as important factors that contributed to lifestyle risk behaviour. In this group, the incidence of smoking was higher than in the general South African population, but binge drinking was the same. The study found that participants seldom met their energy, dietary fibre, vitamin and mineral requirements, and the intake of fat, saturated fat and refined carbohydrates was high. Conclusion: Dietary interventions should be available for all PEMC workers, and the availability of a counsellor to assist workers in dealing with risky lifestyle behaviour could improve PEMC workers’ ability to perform their work. Further research is necessary in order to confirm these results and determine the need for specific interventions.

BACKGROUND:The burden of poverty-related infectious diseases remains high in low- and middle-income countries, while noncommunicable diseases (NCDs) are rapidly gaining importance. To address this dual disease burden, the KaziBantu project aims at improving and promoting health literacy as a means for a healthy and active lifestyle. The project implements a school-based health intervention package consisting of physical education, moving-to-music, and specific health and nutrition education lessons from the KaziKidz toolkit. It is complemented by the KaziHealth workplace health intervention program for teachers. OBJECTIVES:The aim of the KaziBantu project is to assess the effect of a school-based health intervention package on risk factors for NCDs, health behaviors, and psychosocial health in primary school children in disadvantaged communities in Port Elizabeth, South Africa. In addition, we aim to test a workplace health intervention for teachers. METHODS:A randomized controlled trial (RCT) will be conducted in 8 schools. Approximately 1000 grade 4 to grade 6 school children, aged 9 to 13 years, and approximately 60 teachers will be recruited during a baseline survey in early 2019. For school children, the study is designed as a 36-week, cluster RCT (KaziKidz intervention), whereas for teachers, a 24-week intervention phase (KaziHealth intervention) is planned. The intervention program consists of 3 main components; namely, (1) KaziKidz and KaziHealth teaching material, (2) workshops, and (3) teacher coaches. After randomization, 4 of the 8 schools will receive the education program, whereas the other schools will serve as the control group. Intervention schools will be further randomized to the different combinations of 2 additional intervention components: teacher workshops and teacher coaching. RESULTS:This study builds on previous experience and will generate new evidence on health intervention responses to NCD risk factors in school settings as a decision tool for future controlled studies that will enable comparisons among marginalized communities between South African and other African settings. CONCLUSIONS:The KaziKidz teaching material is a holistic educational and instructional tool designed for primary school teachers in low-resource settings, which is in line with South Africa's Curriculum and Assessment Policy Statement. The ready-to-use lessons and assessments within KaziKidz should facilitate the use and implementation of the teaching material. Furthermore, the KaziHealth interventions should empower teachers to take care of their health through knowledge gains regarding disease risk factors, physical activity, fitness, psychosocial health, and nutrition indicators. Teachers as role models will be able to promote better health behaviors and encourage a healthy and active lifestyle for children at school. We conjecture that improved health and well-being increase teachers' productivity with trickle-down effects on the children they teach and train. TRIAL REGISTRATION:International Standard Randomized Controlled Trial Number (ISRCTN): 18485542; http://www.isrctn.com/ISRCTN18485542. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/14097.

Dietary diversity is recognized as vital for health. The level of dietary diversity and contributing factors could possibly be used as proxy indicators for food insecurity and nutritional quality, as well as to highlight gaps in nutrition interventions, policies and programmes, which aim at combating over- and under-nutrition.The aim of this study was to determine the level of dietary diversity and associated factors among adults in the Nelson Mandela Bay area. A convenience, stratified sample of 480 adult participants was used in a survey to determine the level of dietary diversity and identify contributing factors.Adults in the Nelson Mandela Bay area who shopped at shopping malls had a medium level of dietary diversity. Participants consumed on average food from 6.88 +/- 1.73 food groups out of twelve, including sugars and fats. Dietary patterns found were not in line with the South African Food Based Dietary Guidelines. Factors that had a significant association with the level of dietary diversity included ethnicity, level of education, amount of money spent on food purchase per month, distance travelled to purchase food, and nutrition knowledge on dietary diversity. The results are a cause for concern, and justify a call for immediate and effective intervention, including nutrition education promotion and the implementation of current policies and programmes.

Adolescent learners often express independence with risky health behaviour such as poor eating habits, smoking and consuming alcohol. The primary aim of this study was to assess whether a school with an ethos of strict discipline and religious education has an impact on the prevention of risky health behaviour. A health risk behaviour questionnaire was distributed amongst all learners in a private Christian secondary school in order to measure behaviour and attitudes towards eating habits, alcohol and drug intake, exercise, sexual activity, smoking and attitude towards Christian values. A sample of 117 responses from all grades was obtained.The results indicated that these learners were more conservative than learners in other studies. Most had healthy eating habits; 92.3% consumed dairy products, 64.1% consumed more than two fruits and 81.2% more than two vegetables per day. More than 78% exercised regularly. Only 10.2% consumed alcohol, 3.4% smoked and 5.2% used recreational drugs. Of all learners 93.2% believed that their Christian values have an influence on their lifestyle. As it seems that the strict Christian education of these learners lead to less risky health behaviour, ways in which to promote this school’s strategies to other schools, could be investigated. https://doi.org/10.19108/KOERS.82.1.2266

The general wellbeing of primary school children is affected by various factors, of which the lack of foods of high nutritional value. from the National School Nutrition Programme (NSNP) or from lunch boxes, tuck shops and vendors. is one factor. This article reports on sections of the baseline phase of a longitudinal cohort study, as part of an integrated study. The baseline exploratory survey in 2015 conducted structured interviews and observation in eight quintile 3 public primary schools from areas in Nelson Mandela Bay (Eastern Cape). A total of 8 587 children received food from the Department of Basic Education's NSNP. The average expenditure of R2.51 per child per day, including costs for gas and food, makes providing a meal that meets 30% of the nutrient requirements difficult. Only one school had a vegetable garden providing for meals. Four of the eight schools had an acceptable kitchen, but none met all the necessary requirements regarding space and plumbing for the number of children catered for. None of the food providers was trained in basic hygiene and food safety. This was identified as a serious problem, as 60% of the children in the study had one or more types of parasitic infection. Food items from tuck shops and vendors were generally low cost items with little nutritional value. Lunch boxes contained energy food. often refined, processed items low in fibre. The food providers, tuck shop operators, vendors and teachers require nutrition, health and safety education, as well as food garden training.

Leaving home to study together with changes in living arrangements may contribute to unhealthy lifestyles in higher education students. The objectives of this study were to describe eating patterns, physical activity and alcohol use among students at the Nelson Mandela Metropolitan University (NMMU) in the context of student accommodation. A convenience sample (n=619) participated in a cross-sectional electronic self-administered survey after providing informed consent. Of the 257 students who regularly skip meals, significantly more were residing in hostels than in other accommodation. Hostel students also reported a significantly lower consumption of fruit, vegetables and dairy products, with 25% indicating insufficient funds as reason. An inactive lifestyle was reported by 49% (n=296) of participants As long-term health can be affected by lifestyle choices, these findings can be used in intervention strategies to improve behaviour. The researchers recommend that an investigation be undertaken into the social problems that may contribute to risk, especially in hostel students.

Objectives: Students studying towards a qualification in Health Sciences should have more knowledge of a healthy lifestyle than other university students. However, it has been questioned whether or not these students apply such knowledge. While studies have been conducted on the lifestyle habits of students in general, few have compared the practices of Health Science students with those of other students. The objectives of this study were to compare the eating patterns, alcohol consumption and physical activity of Health Science students with those of other students.Design: A cross-sectional study design that utilised an electronic self-administered survey was applied. Data were analysed using SPSS (R) and Pearson's chi-square test (p-value < 0.050).Subjects and setting: A convenience sample (n = 619), consisting of registered students at Nelson Mandela Metropolitan University, participated, after providing informed consent.Outcomes measures: Dietary patterns and frequency of intake, alcohol consumption and physical activity were measured.Results: A statistical difference was not reported between the eating patterns, alcohol consumption and physical activity of Health Science students and those of other students. Most of the students exhibited poor dietary behaviour. For example, 65% of Health Science students and 67% of students in other faculties consumed less than one fruit per day, 70% of Health Science students and 64% of other students consumed less than one vegetable per day, while 91% of Health Science students and 93% of students in other faculties consumed less than two glasses of milk per day. Although not significant, fewer Health Science students (4%) than students of other faculties (9%) consumed alcohol more than twice a week. Binge drinking was more common in Health Science students. Forty-eight per cent of the Health Science students indicated that they were physically inactive, compared to 49% of students in other faculties.Conclusion: Students studying Health Science do not have a healthier lifestyle than other students. Further theory-based intervention studies to determine the reasons for this behaviour need to be undertaken. Strategies should be developed to encourage behavioural change. (C) SAJCN

BACKGROUND:An in-depth epidemiological investigation on intestinal parasite infections in an impoverished area of Port Elizabeth, South Africa provides a unique opportunity for research on its impact on children's physical fitness, cognitive performance and psychosocial health. Additionally, we will screen risk factors for the development of diabetes and hypertension in adulthood.METHODS/DESIGN:A 2-year longitudinal cohort study will be conducted, consisting of three cross-sectional surveys (baseline and two follow-ups), in eight historically black and coloured (mixed race) primary schools located in different townships in Port Elizabeth, South Africa. Approximately 1000 Grade 4 primary schoolchildren, aged 8 to 12 years, will be enrolled and followed. At each survey, disease status, anthropometry and levels of physical fitness, cognitive performance and psychosocial health will be assessed. After each survey, individuals diagnosed with parasitic worm infections will be treated with anthelminthic drugs, while children with other infections will be referred to local clinics. Based on baseline results, interventions will be tailored to the local settings, embedded within the study and implemented in half of the schools, while the remaining schools will serve as controls. Implementation of the interventions will take place over two 8-week periods. The effect of interventions will be determined with predefined health parameters.DISCUSSION:This study will shed new light on the health burden incurred by children in deprived urban settings of South Africa and provide guidance for specific health interventions. Challenges foreseen in the conduct of this study include: (i) difficulty in obtaining written informed consent from parents/guardians; (ii) administration of questionnaires in schools where three languages are spoken (Afrikaans, Xhosa and English); (iii) challenges in grasping concepts of psychosocial health among schoolchildren using a questionnaire; and (iv) loss to follow-up due to the study setting where illiteracy, mobility and violence are common. Finally, designing the health interventions together with local principals and teachers will allow all concerned with the research to bolster a sense of community ownership and sustained use of the interventions after the study has ceased.TRIAL REGISTRATION:Controlled-trials.com; identifier: ISRCTN68411960 (date assigned: 14 February 2014).