Abstract

BackgroundRepeated mass drug administration (MDA) of antihelminthics to at-risk populations is still the main strategy for the control of soil-transmitted helminth (STH) infections. However, MDA, as a stand-alone intervention, does not prevent reinfection. Accordingly, complementary measures to prevent STH reinfection, such as health education and improved sanitation, as part of an integrated control approach, are required to augment the effectiveness of MDA for optimal efficiency and sustainability.ObjectiveThe aim of this study is to determine the impact and generalizability of a school-based health education package entitled The Magic Glasses for STH prevention in the Philippines.MethodsWe conducted a cluster randomized controlled intervention trial, involving 2020 schoolchildren aged 9-10 years, in 40 schools in Laguna Province, Philippines, to evaluate the impact of the school-based health education package for the prevention of STHs. The trial was conducted over the course of 1 year (June 2016 to July 2017). A total of 20 schools were randomly assigned to the intervention arm, in which The Magic Glasses Philippines health education package was delivered with the standard health education activities endorsed by the Philippines Department of Health (DOH) and the Department of Education (DepEd). The other 20 schools comprised the control arm of the study, where the DOH/DepEd’s standard health education activities were done. At baseline, parasitological assessments and a knowledge, attitude, and practice survey were carried out in all schools. In addition, height, weight, and hemoglobin levels were obtained from each child (after parental consent), and their school attendance and academic performance in English and mathematics were accessed from the school records. The baseline and 2 follow-up surveys were completed using the same study measurements and quality-control assessments.ResultsKey results from this cluster randomized intervention trial will shed light on the impact that The Magic Glasses health education package will have against STH infections in schoolchildren in the province of Laguna, located on the Island of Luzon, in the Calabarzon Region of the Philippines.ConclusionsThe results of the trial will be used to assess the generalizability of the impact of The Magic Glasses health education package in different epidemiological and cultural settings, providing evidence for translation of this health education package into public health policy and practice in the Asian region and beyond.Trial RegistrationAustralian New Zealand Clinical Trials Registry number ACTRN12616000508471; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368849International Registered Report Identifier (IRRID)DERR1-10.2196/18419

Highlights

  • Soil-transmitted helminth (STH) infections, including roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), and hookworm (Necator americanus and Ancylostoma duodenale), affect more than a quarter of the world’s population, inhabitants of poorer regions [1]

  • A total of 20 schools were randomly assigned to the intervention arm, in which The Magic Glasses Philippines health education package was delivered with the standard health education activities endorsed by the Philippines Department of Health (DOH) and the Department of Education (DepEd)

  • The baseline and 2 follow-up surveys were completed using the same study measurements and quality-control assessments. Key results from this cluster randomized intervention trial will shed light on the impact that The Magic Glasses health education package will have against soil-transmitted helminth (STH) infections in schoolchildren in the province of Laguna, located on the Island of Luzon, in the Calabarzon Region of the Philippines

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Summary

Introduction

Soil-transmitted helminth (STH) infections, including roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), and hookworm (Necator americanus and Ancylostoma duodenale), affect more than a quarter of the world’s population, inhabitants of poorer regions [1]. The public health importance of STH infections is widely recognized, as they are associated with malnutrition, poor growth and development, iron-deficiency anemia, diminished physical fitness, and impaired cognitive development [3,4,5,6,7]. These features are of particular concern in schoolchildren, who have the highest infection prevalence and intensity of A. lumbricoides and T. trichiura and are at risk of a high burden of hookworm-associated morbidity [3,5,8]. Complementary measures to prevent STH reinfection, such as health education and improved sanitation, as part of an integrated control approach, are required to augment the effectiveness of MDA for optimal efficiency and sustainability

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