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Health-education to prevent worm infections in Chinese schoolchildren

This week's New England Journal of Medicine investigates a health-education package to prevent worm infections in Chinese schoolchildren.

News image

Soil-transmitted helminths are among the most prevalent sources of human infections globally.

Dr Franziska Bieri and colleagues 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.
 
The researchers 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.

Infection with soil-transmitted helminths was 50% lower in the intervention group
New England Journal of Medicine

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.

The research team assessed infection rates, knowledge about soil-transmitted helminths, and hand-washing behavior 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.
 
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.

The team found that the percentage of children who washed their hands after using the toilet was nearly twice as high in the intervention group, and the incidence of infection with soil-transmitted helminths was 50% lower in the intervention group than in the control group.

The research team observed no adverse events immediately after albendazole treatment.
 
Dr Bieri's team concludes, "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."

N Engl J Med 2013; 368: 1603-1612
26 April 2013

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