School-based health education for the control of soil-transmitted helminthiases in Kanchanaburi province, Thailand

Abstract

Soil-transmitted helminthiases are major parasitic diseases that cause health problems world-wide. School-based health education is one of several basic interventions currently recommended by the World Health Organization for the control of these infections. A 3-year programme of health education for the control of soil-transmitted helminths (STH) has recently been completed in four primary schools in the Hauykayeng subdistrict of Thong Pha Phum district, in the Kanchanaburi province of Thailand. Overall, the percentage of the schoolchildren found infected with STH increased between the start of year 1 of the intervention (16.6%) and the end of year 2 (23.8%) but showed signs of falling by the end of year 3 (19.4%). Although none of these year-on-year changes in overall prevalence was statistically significant, some significant trends were detected when the six school grades (i.e. age-groups) were considered separately. The grade showing the highest prevalence of STH infection changed, from grade 6 (representing the oldest children investigated) at the start of year 1 (when grade-1 children were excluded from the survey) to grade 1 (representing the youngest children) at the ends of year 2 and year 3. By the end of year 3, the children in grades 5 and 6 had significantly lower prevalences of infection than the grade-1 subjects. The prevalence of STH infection in the grade-1 children was significantly higher than that in any of the older grades at the end of year 2 and significantly higher than that in grades 3-6 at the end of year 3. These results indicate that the health education had a greater impact on the children in the higher grades (who, presumably had better levels of understanding and practised better, personal, infection prevention) than on the younger children. Although school-based interventions can serve as a useful entry point for parasite control, more effort, including anthelminthic treatment, may be required among the youngest children. The activities need to be sustainable and supported by appropriate school-health policies.

Prevalence of intestinal parasitic infections and associated risk factors for hookworm infections among primary schoolchildren in rural areas of Nakhon Si Thammarat, southern Thailand

“…Hookworms were the most common helminths found in the schoolchildren, which is consistent with previous reports conducted in southern Thailand [ 15 – 17 ]. However, the observed hookworm infection prevalence of 10.7% was lower than reports from a similar study in southern Thailand, which reported a prevalence of 21.1% in 2002 [ 17 ], and a national survey, which reported a prevalence of 15.8% in 2009 [ 15 ]. The lower hookworm infection prevalence in the present study may be due to differences in urbanization, improved knowledge of personal hygiene, and improved environmental sanitation, for example, clean and safe water supply, and effective human and animal waste disposal.…”

“…The sample size was determined using the single proportion population formula: where p = prevalence of intestinal parasites from a previous study, d = margin of error, and Z = the value from a standard normal distribution corresponding to the desired confidence level, which equals 1.96 for a 95% CI. This formula was calculated based on a prevalence rate of 24.1% from a previous study [ 17 ], with a margin of error of 0.05 and a confidence level of 95%. The appropriate sample size was determined to be 286.…”

“…At that time, treatment with a single dose of mebendazole was implemented through a national program [ 16 ]. Twenty years later, in 2002, along with better knowledge of personal health and hygiene and more accessible health services, the hookworm infection prevalence among children decreased to 21.1% [ 17 ]. Currently, due to rapid urbanization in Thailand, parasitic infections are thought to be further decreasing and have been given relatively little attention by the national government.…”

Impact of Health Education on Soil-Transmitted Helminth Infections in Schoolchildren of the Peruvian Amazon: A Cluster-Randomized Controlled Trial

“…Only five studies have previously investigated the efficacy or effectiveness of a health education intervention on STH prevalence or re-infection rates, with one study showing the benefits of such intervention on prevalence [21]–[25]. They, however, do not provide an adequate appreciation of the impact of a health education intervention because of methodological limitations (e.g.…”

When Things Are Not as They Appear: Assessing the Adequacy of Cluster Randomization When Outcome Events Are Rare at Baseline

“…This recognition has served as the basis for school-based health prevention curricula across Africa [11–13], Asia [14, 15], and Latin America [16, 17] including family planning programs [18, 19], nutrition programs [20–22], and tobacco-prevention campaigns [23, 24]. …”