CoChat
Sign Up
Cited by 198Parasites and Host InteractionsChild Nutrition and Water AccessHelminth infection and control

Health-Education Package to Prevent Worm Infections in Chinese Schoolchildren

Open access
Bieri, Franziska A., Gray, Darren J., Williams, Gail M., Raso, Giovanna, Li, Yue-Sheng, Yuan, Liping, He, Yongkang, Li, Robert S. +3 more·2013·New England Journal of Medicine
DOI 10.1056/nejmoa1204885
Open this paper in CoChat — free accountOpen PDF

Abstract

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.).

Integrity signals

Registry

Crossref · 10.1056/nejmoa1204885

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Improving school-based WASH can reduce other hygiene-related diseases, such as soil-transmitted helminth (STH) infection.

    “Improving school-based WASH can also reduce other hygiene-related diseases, such as soil-transmitted helminth (STH) infection [7,21,22].”

    From Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact (2019) · cites this paper as [7]

  • All of the 13 publications that examined changes in WASH knowledge, attitudes and hygiene behaviours reported evidence of positive change among students in intervention schools including hand-washing with soap or sanitizer, improved knowledge of WASH-related diseases, and improved hygiene habits.

    “All of the 13 publications that examined changes in WASH knowledge, attitudes and hygiene behaviours reported evidence of positive change among students in intervention schools including hand-washing with soap or sanitizer [8,16,29,30,31], improved knowledge of WASH-related diseases, and improved hygiene habits [7,13].”

    From Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact (2019) · cites this paper as [7]

  • Fourteen (78%) of the 18 publications that reported disease-related outcomes found reductions in diarrhoeal disease and other hygiene-related diseases, such as respiratory illness and soil-transmitted helminths, among students at intervention schools.

    “Fourteen (78%) of the 18 publications that reported disease-related outcomes found reductions in diarrhoeal disease and other hygiene-related diseases, such as respiratory illness and soil-transmitted helminths, among students at intervention schools (c.f. [7,18,21,28]).”

    From Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact (2019) · cites this paper as [7]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Bieri, F. A., Gray, D. J., Williams, G. M., Raso, G., Li, Y.-S., Yuan, L., He, Y., Li, R. S., Guo, F.-Y., Li, S.-M., & McManus, D. P.
Affiliations
  • Swiss Tropical and Public Health Institute (CH)
  • From Queensland Institute of Medical Research, Herston (F.A.B., D.J.G., Y.-S.L., D.P.M.), and the School of Population Health, University of Queensland, Brisbane (F.A.B., D.J.G., G.M.W., R.S.L.) — both in Australia; the Swiss Tropical and Public Health Institute, Basel (G.R.); Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Ivory Coast (G.R.); and the Hunan Institute of Parasitic Diseases, WHO Collaborating Center for Research and Control on Schistosomiasis in the Lake Region,...
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2013-04-25
Volume
368
Issue
17
Pages
1603-1612
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa1204885
OpenAlex
W2072807527
Cited by
198
References
41
Citations by year
2026: 5 · 2025: 8 · 2024: 15 · 2023: 12 · 2022: 18 · 2021: 22 · 2020: 20 · 2019: 19 · 2018: 15 · 2017: 11 · 2016: 13 · 2015: 18 · 2014: 18 · 2013: 3
FWCI
14.57
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • ANU Open Research (Australian National University) (submittedVersion)
Funders
Centers for Disease Control and Prevention
Topics
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Veterinary › Small Animals › Helminth infection and control
Keywords
soil-transmitted helminths, health education, elementary school students, handwashing behavior, animated cartoons, health education posters, albendazole treatment, rural schools, behavior change
MeSH terms
Anthelmintics, Cartoons as Topic, Child, Child Behavior, China, Female, Hand Disinfection, Health Education, Helminthiasis, Humans, Health Knowledge, Attitudes, Practice, Male, Surveys and Questionnaires, School Health Services, Video Recording, Albendazole, Prevalence, Single-Blind Method, Posters as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review