Health-education package to prevent worm infections in Chinese schoolchildren

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 and McManus, Donald P. (2013) Health-education package to prevent worm infections in Chinese schoolchildren. New England Journal of Medicine, 368 17: 1603-1612. doi:10.1056/NEJMoa1204885

Author 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.
Title Health-education package to prevent worm infections in Chinese schoolchildren
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 0028-4793
Publication date 2013-04
Sub-type Article (original research)
DOI 10.1056/NEJMoa1204885
Volume 368
Issue 17
Start page 1603
End page 1612
Total pages 10
Place of publication Boston, MA, United States
Publisher Massachusetts Medical Society
Collection year 2014
Language eng
Formatted 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.

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.

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.
Keyword Soil-transmitted helminths
Behavioral change
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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