Onset and Pattern of Puberty in Apparently Healthy Sudanese Children: A Cross-Sectional Multi-Center Community-Based Study

<i>Background</i>. Puberty, a stage of development involving sexual maturation, is not well understood in Sudan regarding the onset and pattern of puberty in elementary school boys and girls. <i>Objectives</i>. To investigate the average ages and patterns of pubertal development of male and female school children. <i>Methods</i>. A one-year study involved 1584 students from 50 elementary schools. <i>Result</i>. The study involved 1584 students, with 58.6% male and 41.4% female. The minimum age for pubertal signs was 9 years. Boys showed increased height, body build, interest in adult behavior, acne, gynecomastia, pubic hair growth, axillary hair growth, facial hair growth, while girls showed increased height, breast buds, interest in adult behavior, and menarche. <i>Conclusion</i>. The study revealed that puberty typically begins at 9 years old in both males and females, with pubic hair development occurring before height increase in boys, breast budding and pubic hair appearing later in girls, particularly in Sudan.