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

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Health-Education Package to Prevent Worm Infections in Chinese Schoolchildren

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Bieri, Franziska A., Gray, Darren J., Williams, Gail M., Raso, Giovanna, Li, Yue-Sheng, Yuan, Liping, He, Yongkang, Li, Robert S., Guo, Feng-Ying, Li, Sheng-Ming, McManus, Donald P.·2013·New England Journal of Medicine

DOI 10.1056/nejmoa1204885

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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.).

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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: Bieri, Franziska A.
Gray, Darren J.
Williams, Gail M.
Raso, Giovanna
Yuan, Liping
McManus, Donald P.
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: bronze
doi.org
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
Life Sciences › Immunology and Microbiology › Parasitology › 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

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Health-Education Package to Prevent Worm Infections in Chinese Schoolchildren

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