Nutritional Status and its Related Factors in Khalwa Residents, Khartoum state, Sudan

Introduction Khalwa is an Islamic educational institution, known as such in Sudan and called elsewhere Koranic institution. Our research aimed to assess the nutritional status and its related factors among Khalwa residents in Khartoum State. Methods A facility-based cross-sectional study was implemented in two localities of Khartoum State. A multistage sampling technique was used to selected 1273 residents. At first level, four khalwa were selected in the seven localities of Khartoum State through a stratified random sampling technique. At second level, in each of the khalwa selected, all the residents fulfilling the inclusion and exclusion criteria were included in the study. The collected data were firstly summarized numerically and graphically. Then, associations/differences among variables were determined through chi-square tests and ANOVA. A multinomial logistic regression established the relationship between the nutritional status of the residents and its related factors. All statistical tests were considered statistically significant when p< 0.05. Results The age of 1273 residents varied from 6 to 60 years with an average age of 15 years. Their mean body mass index (BMI) of 16.6±3.4 ranged from 7.8 to 34.0. 73.8% (939/1272) of the residents were undernourished, 23.9% (23.9%, 309/1272) were well nourished and 2.3% (29/1272) were overweight/obese. The statistically significant factors related to the nutritional status of the residents were age (under-nourished p=0.000; well-nourished p=0.004), status in the khalwa (p=0.001 vs p=0.075), resting time (p=0.002 vs p=0.038), practices of hand washing (p=0.165 vs p=0.011) and exercising (p=0.032 vs p=0.027). The food practices, despite their contributions to the model, were not statistically significant (p > 0.05). Discussion The nutritional status of khalwa should be translated urgently in a community-directed intervention based on a partnership involving the affected communities, political and administrative authorities, national, bilateral and international donors to overcome the burden of malnutrition.


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Malnutrition challenges the world with one in three people directly affected by underweight, vitamin 75 and mineral deficiency, overweight, obesity and diet-related non-communicable diseases. These  The data were collected through a standardized interviewer-administrated tool, firstly developed in 153 English and translated in Arabic for easy understanding by the study participants. The questionnaire was 154 pre-tested prior to the study implementation in Al Khartoum and Ombadda localities.

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The questionnaire comprised two parts. Part ,1 related to the institution, enabled to collected data, from 156 each Khalwa through observations and interviews to gather statistics on residents, accommodation, 157 sources of water and energy as well as environmental hygiene and sanitation including waste 158 management. Part 2 recorded data related to the study participants through four subheadings the 159 sociodemographic characteristics of the participants, their mode of living, their nutritional practices and 160 their anthropometric measures (height, weight and Body mass index). The anthropometric measures 161 weight (kg) and height (cm) were recorded for all the residents in using Floor type weight scale (model 162 Zt-120). The weight and height were measured in having each resident in minimum clothes, without 163 shoes and having each the head upright and looking straight forward. A relational database was 164 developed through EPI-Info TM 7.1.5.2 2 for easy data entry, to avoid duplication and to minimize data 165 entry errors in the two parts of questionnaire linked through a unique code created based of the Khalwa 166 code and the participant identification number.

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The statistical package for social sciences (SPSS version 23) was used to summarize the data 168 numerically (mean, standard deviation, median) and graphically (frequency tables and graphics). Chi-169 square tests were used to determine association between categorical variables; analysis of variance were students (94.4%, 1201/1273) and the remaining 5.6% (72/1273) were either teachers or supervisors.

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The mean duration of living in the Khalwa of 8.3 years±8.2 was higher for supervisors than teachers 200 (6.3 years±6.9) and students (1.3 years±1.3) and this difference was statistically significant (p=0.000).

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The association between age of the residents and the years of living in Khalwa was also statistically 202 significant (p=0.000). Mode of living of the study participants to the age of the residents, the resting time was lower in the younger age groups: 6.4 hours±0.6 (< 15 217 years) and 6.9 hours±0.6 (15-24 years). In the age groups ≥ 25 years it ranged from 7.1±0.8 (≥35 years) 218 to 7.2±0.6 (25-34 years). The resting time of the students of 6.6 hours±0.6 was lower than of the teachers 219 (7.0 hours±0.8) and supervisors (7.1 hours±0.8). A statistically significant difference was found between 220 resting time and institutions (p=0.000), age groups (p=0.000) and status of the residents (p=0.000).      3.1%, meat and fish 3.4% and fruits 4.1%.

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Our study revealed that the resting time of the residents ranged from 5 to 8 hours with an average of 6.7 385 hours±0.7. This average was lower (6.6 hours±0.6) in the group of students than in teachers (7.0 386 hours±0.8) and supervisors (7.1 hours±0.8) with a statistically significant difference (p=0.00) between 387 an average of 35 residents/bedroom and 5 residents/bed. Improved pit latrine was the most frequent  anonymous research tool. The participants were reassured that the data collected from them will not be