Abstract
BackgroundHealth promotion is essential to the SAFE strategy for trachoma elimination. Schools are a valuable venue for health promotion. However, there is little literature about the impact of health education and water infrastructure in schools on facial cleanliness and trachoma in the community. Our study aimed to describe the current state of school health promotion in Kongwa, Tanzania, and to examine the transferability of health messages from schools to the community at large.Methodology/FindingsA cross-sectional survey was carried out in all 92 villages in Kongwa district, which included 85 primary schools. Data were collected on health messages and water infrastructure in the schools. A random sample of 3084 children aged 0–5 were examined for facial cleanliness in all villages. In 50 villages, a random sample of 50 children aged 1–9 per village were examined for follicular trachoma (TF). Thirty-seven (44.6%) schools had educational materials on face-washing. Fifty (60.2%) schools had a washing station. The presence of a health teacher was correlated with having posters on face washing in classrooms. The presence of face-washing materials was correlated with the availability of washing stations. Neither teachers mentioning face-washing in health curricula nor educational materials in classrooms were associated with clean faces or trachoma in the community. Having a washing station in the school was associated with lower community rates of trachoma.ConclusionsPrimary school health messages and materials on trachoma were not associated with clean faces or lower rates of trachoma in the community. The target audience for primary school health promotion is likely the students themselves, without immediate rippling effects in the community. A long-term perspective should be considered during the implementation of health promotion in schools. The goal of school health promotion should be training the next generation of parents and community health leaders in combatting trachoma.
Highlights
Trachoma is a leading infectious cause of blindness globally, with 137 million people living in trachoma-endemic areas [1]
Our study aimed to describe the current state of school health promotion in Kongwa, Tanzania, and to examine the transferability of health messages from schools to the community at large
Primary school health messages and materials on trachoma were not associated with clean faces or lower rates of trachoma in the community
Summary
Trachoma is a leading infectious cause of blindness globally, with 137 million people living in trachoma-endemic areas [1]. Trachoma is the result of repeated infection with Chlamydia trachomatis (C. trachomatis), which causes conjunctivitis in young children [2]. Active trachoma can manifest as follicular trachomatous inflammation (TF) of the upper tarsal conjunctiva. Repeat episodes of infection lead to chronic inflammation, which causes scarring of the conjunctiva (trachomatous scarring). Conjunctival scarring can lead to the in-turning of the eyelid (entropion) as well as the eyelashes (trachomatous trichiasis). Health promotion is essential to the SAFE strategy for trachoma elimination. Schools are a valuable venue for health promotion. There is little literature about the impact of health education and water infrastructure in schools on facial cleanliness and trachoma in the community. Our study aimed to describe the current state of school health promotion in Kongwa, Tanzania, and to examine the transferability of health messages from schools to the community at large
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