Assessing Preparedness and Preventive Measures for Managing Food Allergy and Anaphylaxis in Primary Schools of Rabigh, Saudi Arabia

Background and Aims: Anaphylaxis is a severe allergic reaction that can lead to life-threatening consequences. Despite growing awareness of food allergies, schools in Saudi Arabia remain underprepared to manage allergic reactions. This study aimed to evaluate the preparedness of primary schools in Rabigh, Saudi Arabia, in managing allergic reactions, with a focus on their policies and training practices to prevent food-related anaphylaxis. Methods: A cross-sectional survey was conducted involving 24 primary schools in Rabigh. An online questionnaire, previously validated for assessing school preparedness, was distributed to school administrators. The questionnaire covered preparedness to manage allergic reactions and existing protocols for allergy management. Data were analysed using IBM SPSS Statistics version 25 to determine the association between preparedness level and the presence of pupils with food allergies or anaphylaxis. Results: Nineteen schools (79%) completed the survey. Most schools (95%) had emergency communication systems, and 74% designated a staff member to manage allergic reactions. However, only 58% were aware of pupils with food allergies. Preventive measures such as food-handling guidance and a no-nut policy were present in most schools. Still, policies against food sharing and closer supervision of high-risk pupils were inconsistently implemented. A comparison between schools with and without pupils with allergies revealed that schools with such pupils were more likely to identify allergy risks and provide closer supervision during mealtimes (p = 0.042). Conclusion: Although some schools in the Rabigh region have implemented basic allergy emergency systems, significant gaps in preparedness remain, particularly in preventive measures and the supervision of high-risk pupils. The study highlights the need for standardized policies and regular training to enhance preparedness, especially in schools without known pupils with allergies, in order to ensure a safe educational environment.