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 all 24 primary schools in Rabigh. We used a previously published questionnaire that was translated into Arabic and contextually adapted; however, no formal psychometric validation was performed. The questionnaire assessed school preparedness to manage allergic reactions and existing protocols for allergy management. Data were analysed using IBM SPSS Statistics version 25 to examine associations between preparedness level and the presence of pupils with food allergy 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). Conclusions: While some primary schools in Rabigh reported strengths such as designated staff and emergency communication systems, substantial gaps were observed in preventive measures, including mealtime supervision and food-sharing policies. Preparedness varied across schools, with those without known allergic pupils less likely to implement preventive practices. These findings underscore the importance of standardised policies and regular staff training to ensure readiness for allergic emergencies in all schools.