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Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania

INTRODUCTION: Soil transmitted helminths (STH) can affect over 50% of children in some parts of Tanzania. Control measures involve annual deworming campaigns in schools, but re-infection is rapid. This paper presents the design and baseline survey results of an ongoing school-based cluster-randomise...

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Autores principales: Makata, Kenneth, Kinung’hi, Safari, Hansen, Christian, Ayieko, Philip, Sichalwe, Simon, Mcharo, Onike, Ensink, Jeroen, Dreibelbis, Robert, Rockowitz, Sarah, Okello, Elialilia, Grosskurth, Heiner, Kapiga, Saidi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725373/
https://www.ncbi.nlm.nih.gov/pubmed/33296365
http://dx.doi.org/10.1371/journal.pone.0242240
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author Makata, Kenneth
Kinung’hi, Safari
Hansen, Christian
Ayieko, Philip
Sichalwe, Simon
Mcharo, Onike
Ensink, Jeroen
Dreibelbis, Robert
Rockowitz, Sarah
Okello, Elialilia
Grosskurth, Heiner
Kapiga, Saidi
author_facet Makata, Kenneth
Kinung’hi, Safari
Hansen, Christian
Ayieko, Philip
Sichalwe, Simon
Mcharo, Onike
Ensink, Jeroen
Dreibelbis, Robert
Rockowitz, Sarah
Okello, Elialilia
Grosskurth, Heiner
Kapiga, Saidi
author_sort Makata, Kenneth
collection PubMed
description INTRODUCTION: Soil transmitted helminths (STH) can affect over 50% of children in some parts of Tanzania. Control measures involve annual deworming campaigns in schools, but re-infection is rapid. This paper presents the design and baseline survey results of an ongoing school-based cluster-randomised controlled trial in Kagera region, NW Tanzania. The trial aims to determine whether the effect of routine deworming on the prevalence of Ascaris lumbricoides and Trichuris trichiura infections among school aged children can be sustained when combined with a behaviour change intervention promoting handwashing with water and soap. METHODS: As part of the trial, a total of 16 schools were randomised to receive the intervention (N = 8) or as controls (N = 8). Randomisation was stratified per district and restricted to ensure pre-trial STH prevalence was balanced between study arms. The combination intervention to be tested comprises class-room based teacher-led health education, improvement of handwash stations, coloured nudges to facilitate handwashing and parental engagement sessions. The impact evaluation involves two cross-sectional surveys conducted at baseline and endline. The objectives of the baseline survey were: (i) to confirm whether the deworming campaign was successful, and identify and treat students still infected about 2 weeks after deworming, (ii) to document any baseline differences in STH prevalence between trial arms, and (iii) to assess handwashing behaviours, and access to water and sanitation at school and home. We randomly sampled 35 students per class in Grades 1–6 (an average of 200 children per school), stratified to ensure equal representation between genders. Assenting students were interviewed using a structured questionnaire and asked to provide a stool specimen. RESULTS: Results of the baseline survey conducted about 2 weeks after deworming shows balanced demographic and STH prevalence data across trial arms. We observed a low prevalence of ascariasis (< 5%) as expected; however, the prevalence of trichuriasis was still about 35% in both arms. CONCLUSION: The randomisation procedure was successful in achieving a balanced distribution of demographic characteristics and helminth infections between trial arms. The intervention is being rolled out. The current deworming treatment regimen may need to be revised with regards to the treatment of trichuriasis.
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spelling pubmed-77253732020-12-16 Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania Makata, Kenneth Kinung’hi, Safari Hansen, Christian Ayieko, Philip Sichalwe, Simon Mcharo, Onike Ensink, Jeroen Dreibelbis, Robert Rockowitz, Sarah Okello, Elialilia Grosskurth, Heiner Kapiga, Saidi PLoS One Research Article INTRODUCTION: Soil transmitted helminths (STH) can affect over 50% of children in some parts of Tanzania. Control measures involve annual deworming campaigns in schools, but re-infection is rapid. This paper presents the design and baseline survey results of an ongoing school-based cluster-randomised controlled trial in Kagera region, NW Tanzania. The trial aims to determine whether the effect of routine deworming on the prevalence of Ascaris lumbricoides and Trichuris trichiura infections among school aged children can be sustained when combined with a behaviour change intervention promoting handwashing with water and soap. METHODS: As part of the trial, a total of 16 schools were randomised to receive the intervention (N = 8) or as controls (N = 8). Randomisation was stratified per district and restricted to ensure pre-trial STH prevalence was balanced between study arms. The combination intervention to be tested comprises class-room based teacher-led health education, improvement of handwash stations, coloured nudges to facilitate handwashing and parental engagement sessions. The impact evaluation involves two cross-sectional surveys conducted at baseline and endline. The objectives of the baseline survey were: (i) to confirm whether the deworming campaign was successful, and identify and treat students still infected about 2 weeks after deworming, (ii) to document any baseline differences in STH prevalence between trial arms, and (iii) to assess handwashing behaviours, and access to water and sanitation at school and home. We randomly sampled 35 students per class in Grades 1–6 (an average of 200 children per school), stratified to ensure equal representation between genders. Assenting students were interviewed using a structured questionnaire and asked to provide a stool specimen. RESULTS: Results of the baseline survey conducted about 2 weeks after deworming shows balanced demographic and STH prevalence data across trial arms. We observed a low prevalence of ascariasis (< 5%) as expected; however, the prevalence of trichuriasis was still about 35% in both arms. CONCLUSION: The randomisation procedure was successful in achieving a balanced distribution of demographic characteristics and helminth infections between trial arms. The intervention is being rolled out. The current deworming treatment regimen may need to be revised with regards to the treatment of trichuriasis. Public Library of Science 2020-12-09 /pmc/articles/PMC7725373/ /pubmed/33296365 http://dx.doi.org/10.1371/journal.pone.0242240 Text en © 2020 Makata et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Makata, Kenneth
Kinung’hi, Safari
Hansen, Christian
Ayieko, Philip
Sichalwe, Simon
Mcharo, Onike
Ensink, Jeroen
Dreibelbis, Robert
Rockowitz, Sarah
Okello, Elialilia
Grosskurth, Heiner
Kapiga, Saidi
Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania
title Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania
title_full Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania
title_fullStr Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania
title_full_unstemmed Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania
title_short Hand hygiene intervention to optimize helminth infection control: Design and baseline results of Mikono Safi–An ongoing school-based cluster-randomised controlled trial in NW Tanzania
title_sort hand hygiene intervention to optimize helminth infection control: design and baseline results of mikono safi–an ongoing school-based cluster-randomised controlled trial in nw tanzania
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725373/
https://www.ncbi.nlm.nih.gov/pubmed/33296365
http://dx.doi.org/10.1371/journal.pone.0242240
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