03471nas a2200481 4500000000100000008004100001653002000042653003100062653002400093653002700117653001500144653002100159653000900180653001100189653001800200653004200218653002100260653002200281653001100303653001000314653001900324653001000343653002200353653001800375653001600393100001200409700001100421700001500432700001100447700000900458700001100467700000900478700000900487700001000496700000900506700001400515245008300529856005400612300001200666490000800678520228900686022001402975 2013 d10aVideo Recording10aSurveys and Questionnaires10aSingle-Blind Method10aSchool Health Services10aPrevalence10aPosters as Topic10aMale10aHumans10aHelminthiasis10aHealth Knowledge, Attitudes, Practice10aHealth Education10aHand Disinfection10aFemale10aChina10aChild Behavior10aChild10aCartoons as Topic10aAnthelmintics10aAlbendazole1 aBieri F1 aGray D1 aWilliams G1 aRaso G1 aLi Y1 aYuan L1 aHe Y1 aLi R1 aGuo F1 aLi S1 aMcManus D00aHealth-education package to prevent worm infections in Chinese schoolchildren. uhttp://www.nejm.org/doi/pdf/10.1056/NEJMoa1204885 a1603-120 v3683 a
BACKGROUND: Soil-transmitted helminths are among the most prevalent sources of human infections globally. We determined the effect of an educational package at rural schools in Linxiang City District, Hunan province, China, where these worms are prevalent. The intervention aimed to increase knowledge about soil-transmitted helminths, induce behavioral change, and reduce the rate of infection.
METHODS: We conducted a single-blind, unmatched, cluster-randomized intervention trial involving 1718 children, 9 to 10 years of age, in 38 schools over the course of 1 school year. Schools were randomly assigned to the health-education package, which included a cartoon video, or to a control package, which involved only the display of a health-education poster. Infection rates, knowledge about soil-transmitted helminths (as assessed with the use of a questionnaire), and hand-washing behavior were assessed before and after the intervention. Albendazole was administered in all the participants at baseline and in all the children who were found to be positive for infection with soil-transmitted helminths at the follow-up assessment at the end of the school year.
RESULTS: At the follow-up assessment, the mean score for the knowledge of helminths, calculated as a percentage of a total of 43 points on a questionnaire, was 90% higher in the intervention group than in the control group (63.3 vs. 33.4, P<0.001), the percentage of children who washed their hands after using the toilet was nearly twice as high in the intervention group (98.9%, vs. 54.2% in the control group; P<0.001), and the incidence of infection with soil-transmitted helminths was 50% lower in the intervention group than in the control group (4.1% vs. 8.4%, P<0.001). No adverse events were observed immediately (within 15 minutes) after albendazole treatment.
CONCLUSIONS: The health-education package increased students' knowledge about soil-transmitted helminths and led to a change in behavior and a reduced incidence of infection within 1 school year. (Funded by UBS Optimus Foundation, Zurich, Switzerland; Australian New Zealand Clinical Trials Registry number, ACTRN12610000048088.).
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