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Health-Education Package to Prevent Worm Infections in Chinese Schoolchildren

Bieri, Franziska A; Gray, Darren; Williams, Gail; Raso, Giovanna; Li, Yue-Sheng; Yuan, Liping; He, Yongkang; Li, Robert S; Guo, Feng-Ying; Li, Sheng-Ming; McManus, Donald P

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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...[Show more]

dc.contributor.authorBieri, Franziska A
dc.contributor.authorGray, Darren
dc.contributor.authorWilliams, Gail
dc.contributor.authorRaso, Giovanna
dc.contributor.authorLi, Yue-Sheng
dc.contributor.authorYuan, Liping
dc.contributor.authorHe, Yongkang
dc.contributor.authorLi, Robert S
dc.contributor.authorGuo, Feng-Ying
dc.contributor.authorLi, Sheng-Ming
dc.contributor.authorMcManus, Donald P
dc.date.accessioned2015-12-10T23:04:18Z
dc.identifier.issn0028-4793
dc.identifier.urihttp://hdl.handle.net/1885/62311
dc.description.abstractBACKGROUND: 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.)
dc.publisherMassachusetts Medical Society
dc.sourceNew England Journal of Medicine
dc.subjectKeywords: albendazole; article; ascariasis; attitude to health; child; Chinese; controlled study; drug efficacy; female; follow up; hand washing; human; incidence; infection prevention; infection rate; male; prevalence; priority journal; randomized controlled trial
dc.titleHealth-Education Package to Prevent Worm Infections in Chinese Schoolchildren
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume368
dc.date.issued2013
local.identifier.absfor111799 - Public Health and Health Services not elsewhere classified
local.identifier.ariespublicationU3488905xPUB686
local.type.statusPublished Version
local.contributor.affiliationBieri, Franziska A, Queensland Institute of Medical Research,
local.contributor.affiliationGray, Darren, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationWilliams, Gail, University of Queensland
local.contributor.affiliationRaso, Giovanna, Swiss Tropical and Public Health Institute
local.contributor.affiliationLi, Yue-Sheng, Queensland Institute of Medical Research
local.contributor.affiliationYuan, Liping, Hunan Institute of Parasitic Diseases
local.contributor.affiliationHe, Yongkang, Hunan Institute of Parasitic Diseases
local.contributor.affiliationLi, Robert S, University of Queensland
local.contributor.affiliationGuo, Feng-Ying, Hunan Institute of Parasitic Diseases
local.contributor.affiliationLi, Sheng-Ming, Hunan Institute of Parasitic Diseases
local.contributor.affiliationMcManus, Donald P, University of Queensland
local.description.embargo2037-12-31
local.bibliographicCitation.issue17
local.bibliographicCitation.startpage1603
local.bibliographicCitation.lastpage1612
local.identifier.doi10.1056/NEJMoa1204885
local.identifier.absseo920499 - Public Health (excl. Specific Population Health) not elsewhere classified
dc.date.updated2016-02-24T10:12:30Z
local.identifier.scopusID2-s2.0-84876548302
local.identifier.thomsonID000317956300009
CollectionsANU Research Publications

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