School Hygiene Research Articles

Inner Front Cover Image

ON THE INNER FRONT COVER: Septin‐caged Shigella flexneri in infected HEK293 cells. Bacteria and actin are labelled in red, SEPT7 in green, and DNA in blue.Credit: Gizem Ozbaykal‐Guler and Serge Mostowy, London School of Hygiene & Tropical Medicineimage

Protocol for a cluster randomised placebo-controlled trial of adjunctive ivermectin mass drug administration for malaria control on the Bijagós Archipelago of Guinea-Bissau: the MATAMAL trial

IntroductionAs malaria declines, innovative tools are required to further reduce transmission and achieve elimination. Mass drug administration (MDA) of artemisinin-based combination therapy (ACT) is capable of reducing malaria transmission where...

Life histories of the founders of Kharkiv school of hygiene

This article describes the life history of the founders of Kharkiv school of hygiene Arkadiy Ivanovich Yakobiy (1827–1907) and Ezro Musiyovych Kahan (1887–1948). It is dedicated to the 150th anniversary of the Department of Hygiene and Ecology No.1 of Kharkiv National Medical University (KhNMU) and the 100th anniversary of Research Institute of Occupational Hygiene and Occupational Diseases. Both of these talented individuals left their places of birth, secondary and higher education at some point, due to certain unfavorable consequences of regional life, and arrived in prosperous Kharkiv. Having a wide range of knowledge, both worked in a wide aspect of science and practice that relate to the general well-being of various categories of the population, including environmental, household, epidemic, production, family and other statuses of human life. Both came to the conclusion that identifying and overcoming risk factors for health deterioration is a very promising direction for achieving global well-being of humanity. Based on this, both became the founders of the Kharkiv School of Hygiene. Yakobiy A.I. founded the first department of hygiene at Kharkiv University оn February 1, 1873, and headed it for the following 12 years. Kahan E.M. headed specialized institute for workers' health problems (the first on the territory of the USSR), namely the Institute of Occupational Medicine, іn May 1923, and managed it until 1931. During the term of their work at Kharkiv hygienic institutions, these professors provided a methodological basis for the multi-decade development of the corresponding scientific, pedagogical and practical field of state health care. Keywords: historical aspects, scientific research, health care, lifestyle, professor Yakobiy A.I., professor Kahan E.M.

Modeling vaccination coverage during the 2022 central Ohio measles outbreak: a cross-sectional study

Of the eight large (>50 cases) US postelimination outbreaks, the first and last occurred in Ohio. Ohio's vaccination registry is incomplete. Community-level immunity gaps threaten more than two decades of measles elimination in the US. We developed a statistical model, VaxEstim, to rapidly estimate the early-phase vaccination coverage and immunity gap in the exposed population during the 2022 Central Ohio outbreak. We used reconstructed daily incidence (from publicly available data) and assumptions about the distribution of the serial interval, or the time between symptom onset in successive measles cases, to estimate the effective reproduction number (i.e., the average number of secondary infections caused by an infected individual in a partially immune population). We estimated early-phase measles vaccination coverage by comparing the effective reproduction number to the basic reproduction number (i.e., the average number of secondary infections caused by an infected individual in a fully susceptible population) while accounting for vaccine effectiveness. Finally, we estimated the early-phase immunity gap as the difference between the estimated critical vaccination threshold and vaccination coverage. VaxEstim estimated the early-phase vaccination coverage as 53% (95% credible interval, 21%-77%), the critical vaccination threshold as 93%, and the immunity gap as 42% (95% credible interval, 18%-74%). This study estimates a significant immunity gap in the exposed population during the early phase of the 2022 Central Ohio measles outbreak, suggesting a robust public health response is needed to identify the susceptible community and develop community-specific strategies to close the immunity gap. This work was supported in part by the National Institute of General Medical Sciences, National Institutes of Health; the UK Medical Research Council (MRC); the Foreign, Commonwealth and Development Office; the National Institute for Health Research (NIHR) Health Protection Research Unit in Modelling Methodology; Imperial College London, and the London School of Hygiene & Tropical Medicine, Community Jameel; the EDCTP2 programme, supported by the EU; and the Sergei Brin Foundation.

Pengaruh Program Kurassaki (Kurangi Sampah Sekolah Kita) Terhadap Kebersihan Sekolah Pada Siswa di SDN Kutabaru I Kabupaten Tangerang

This study aims to determine the effect of the kurassaki (reduce our school waste) programme on school hygiene in students at SDN Kutabaru I, Tangerang Regency. The research approach used is quantitative with correlational method. The data in this study were obtained through distributing questionnaires to respondents and analysed using simple regression tests and correlation tests. The location of this research was SDN Kutabaru I, Tangerang Regency. The population in this study were all students at SDN Kutabaru I, Tangerang Regency. The sampling technique in this study used random sampling technique and the number of samples was determined using the Solvin formula with a significance level of 5% so that the number of samples in this study was 264 respondents. The results of simple regression testing obtained Fcount 81.71> Ftable 1.22 with the equation Y = 33.79 + 0.53X. This shows that there is a significant influence between the kurassaki (reduce our school waste) programme on school hygiene. Meanwhile, the results of correlation testing obtained an rxy value of 0.48 which is based on the table of criteria for determining the amount of correlation coefficient is at the "medium" level, and obtained a determinant coefficient value of 24% which shows how much influence the kurassaki (reduce our school waste) programme contributes to school hygiene.

The Financial Cost of Managing Menstrual Hygiene in Schools in the Health District of Bla in Mali

Introduction: Many women and girls face financial challenges in meeting their menstrual hygiene management needs. The main objective of this study is to estimate the financial cost of menstrual hygiene management among school-going girls. Methodology: This is a prospective study carried out in a semi-urban school environment at the Public High School in the health district of Bla in 2020. Results: This study was conducted among 125 high school girls with no income. The average age was 18 years old. Parents lived in rural areas with no fixed monthly income in 52% of cases. Multipurpose pieces of cloth were the protective material used in 67% of cases. The girls explained this choice in 100% of cases by the high cost of single pads and tampons. The average monthly cost of menstrual hygiene management was 0, 56 $ or 6, 67 $ per year with extremes of 0, 16 and 2, 45 $ per month. This amount was used to buy either single-use pads or soap for body care and multiple-use pads. This financial cost was covered at 92% by female support (mother, aunt, sister); male support (father, spouse) accounted for only 8%. Conclusion: This study made it possible to estimate the average annual financial cost of menstrual hygiene management among young school girls in Bla. These findings call for further studies to better understand the financial implications of menstrual hygiene management in low-resource settings.

Bibliometric and visual analysis of vaccination hesitancy research from 2013 to 2022

ABSTRACT Although vaccination is regarded as one of the most significant achievements of public health, there also exists the phenomenon of vaccination hesitancy which refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. In this study, we conducted a bibliometric analysis to provide a comprehensive overview of vaccination hesitancy research from 2013 to 2022. All related publications were retrieved from the Web of Science Core Collection Database. Information on annual publications, countries, organizations, journals, authors, keywords, and documents was analyzed adopting the bibliometix R-package, VOSviewer, and CiteSpace software. A total of 4042 publications were enrolled. The annual publications increased slightly before 2020 but had an extremely dramatic increase from 2020 to 2022. The United States contributed the most articles and had the greatest collaboration with other countries and organizations. The London School of Hygiene & Tropical Medicine was the most active institution. Vaccine was the most cited and influential journal while Vaccines was the most productive journal. It was Dube E who was the most productive authors with the highest h-index. The most frequent keywords were “vaccine hesitancy,” “COVID-19,” “SARS-CoV2,” “immunization,” “attitudes,” and “willingness.” Vaccination hesitancy to some extent hinders the achievement of global public health. The influencing factors vary across time, space, and vaccines. The COVID-19 pandemic and the development of COVID-19 vaccines have made this issue the focus of interest. The complexity and specific contexts of influencing factors of vaccination hesitancy require further study and will potentially be the focus of future research direction.

Physical education of children and youth as a mandatory component of pedagogical works in Romania in the second half of the 19th - beginning of the 20th century

The authors of the article "Physical education of children and youth as a mandatory component of pedagogical works in Romania in the second half of the 19th - beginning of the 20th century." O. Tsybanyuk, A. Moldovan, and S. Dariіchuk determined that the recognition of physical education as a mandatory component of the educational process for children and youth in the country was proven by the active appearance of thematic training courses, textbooks, and monographs in the studied period. Such were the textbooks of I. Popescu "Pedagogy", the monograph of S. Velovan and I. Popescu "Pedagogy", which paid attention to the influence of systematic gymnastic exercises on the education of order, accuracy and discipline, morality and aesthetics. In addition, an analysis of the characteristics of alternation of physical activity and rest was found. An interesting element was the characteristic of the body of educational articles in the journal "Pedagogical Body for Education and Training". An example was the requirement for teachers to take into account physical activity and rest, the "weight of the school", to be able to diversify it through mobile and folk games. Separate recommendations of P. Pipos regarding the use of food, air, movement-games and gymnastics as means of physical education, as well as methodical instructions for conducting a physical education lesson. In the opinion of the researcher, advice to teachers about the use of well-thought-out, planned exercises and complexes is relevant. It has been proven that, in addition to pedagogical publications, specialized publications appeared during this time – "Considerations about the importance and necessity of gymnastics from a hygienic and social point of view in schools of both sexes, in the army, at different ages of life and as a treatment for various diseases" by Dr. K.I. Istrati, "Physical education" by I. Slavicha, section "Physical education" authored by V. Gidionescu in the work "School hygiene", etc.

Overview of Knowledge Level and Status of Oral Hygiene in Aceh Besar State Elementary School Students

Teaching children about the importance of dental and oral hygiene from an early age is a long-term investment in their health. Parents and caregivers have an important role in guiding children to maintain regular dental and oral hygiene. Good dental care habits should be taught from an early age, including brushing teeth twice a day, using age-appropriate fluoride-containing toothpaste, flossing teeth, and visiting the dentist regularly. This study aimed to provide an overview of aspects of knowledge and status of students' dental and oral hygiene in state elementary schools in Aceh Besar, Indonesia. The descriptive observational study, where as many as 44 research subjects participated in this study. Observation of knowledge and oral health status was carried out univariately using SPSS. In conclusion, the knowledge of Aceh Besar, state elementary school students, is still relatively poor regarding oral health. The dental and oral health status of Aceh Besar state elementary school students is classified as moderate.

Precision Public Health Opportunity: Heat-Associated Mortality Greater among Pilgrims during Hajj

Precision Public Health Opportunity: Heat-Associated Mortality Greater among Pilgrims during Hajj

Coinfections of malaria and sexually transmitted and reproductive tract infections in pregnancy in sub-Saharan Africa: a systematic review and individual participant data meta-analysis protocol

IntroductionMalaria infection and curable sexually transmitted infections and reproductive tract infections (STIs/RTIs) adversely impact pregnancy outcomes. In sub-Saharan Africa, the prevalence of malaria and curable STIs/RTIs is high and, where...

Are target trial emulations the gold standard for observational studies?

1 Department of Medical Statistics London School of Hygiene and Tropical Medicine, UK 2 Leiden University Medical Center Dept. Clinical Epidemiology PO Box 9600 2300 RC Leiden, The Netherlands 3 Department of Clinical Epidemiology, Aarhus University, Denmark. Editor’s Note: Related articles can be found on pp. XXX, XXX, and XXX. Conflicts of interest: None declared Acknowledgments: We thank Matt Fox and Elizabeth Williamson for comments on the draft manuscript, and George Davey Smith for useful discussions of these issues. Correspondence to: Professor Neil Pearce Department of Medical Statistics London School of Hygiene and Tropical Medicine, UK Email: [email protected] Phone: 020-79588151

Evaluating Implementation Status of the National Guidelines for Covid-19 Hygiene and Sanitation in Primary Schools of Marsabit County, Kenya

Globally, erupting in late 2019 in China, COVID-19 pandemic became a monumental public health policy problem and threat to humanity of our time. As of June 13, 2021, the pandemic affected close to 176 million people and caused over 3.8 million deaths and disrupted global economies leading to loss of jobs and livelihoods. From a public health perspective, African countries like Kenya, need greater investments in water, sanitation and hygiene (WASH) interventions as the first line of defence to effectively mitigate against the pandemic. The objective of this study was to identify and assess the level and status of hygiene and sanitation implementation of COVID-19 national guidelines in four schools in three sub counties of Marsabit County in northern Kenya. COVID-19The study adopted a cross sectional design and mixed method in data collection. In addition, review of secondary literature both quantitative and qualitative data were collected during October to December 2022. Data was collected through administering questionnaires targeting 284 respondents, key informant interviews and focused group discussions with selected opinion leaders. Quantitative data was analysed using SPSS ver25 and univariate and bivariate statistical techniques were applied. Descriptive analysis using thematic technique was used to analyse qualitative data. The study findings observed that the current school based intervention for COVID-19 prevention included wearing of face masks (86%), practicing social distance (65%), hand washing with water (52%), and using alcohol based hand sanitizers (64%). It also revealed key factors influencing covid19 interventions: barriers to uptake included: lack of enforcement (84.2%), shortage of WASH facilities (78.9%), lack of funds (76.8%), lack of trained staff (70.4%), inadequate facilities (88.7%), lack of awareness (50.0%), poor attitude and ignorance (76.4%), accessibility (37.3%), cultural and religious factors (70.1%).This study concludes that while knowledge of transmission and prevention were found to be high; access to many of the essential support systems and WASH facilities remain a major challenge in the schools in Marsabit. These challenges were also identified from the findings of qualitative study. The study advances key recommendations notably: promotion of school-based training and sensitization of teachers and workers; increased financial support for provision of hygiene and sanitation facilities and preventive support supplies; expansion of community sensitization using radio, television, mass media and school drama clubs; and finally, enhanced financial and budgetary support from national and county governments, donors, and non-governmental organizations to implement robust WASH interventions especially in schools in the Arid and Semi-Arid regions of Kenya.

School-based preventive chemotherapy program for schistosomiasis and soil-transmitted helminth control in Angola: 6-year impact assessment.

A school preventive chemotherapy (PC) program for soil-transmitted helminths (STHs) and schistosomiasis has operated in Huambo, Uige and Zaire provinces, Angola, since 2013 and 2014, respectively; complemented by a school water, sanitation and hygiene (WASH) program in a subset of schools from 2016. Conducted in 2021, this is the first impact assessment of the school program for the control of schistosomiasis and STHs. A two-stage cluster design was used to select schools and schoolchildren for parasitological and WASH surveys. The rapid diagnostic tests (RDTs), point of care circulating cathodic antigen (POC-CCA) and Hemastix, were used to estimate Schistosoma mansoni and Schistosoma haematobium prevalence, respectively. Kato Katz was used to detect STHs, and quantify STH and S. mansoni infections. Urine filtration was used to quantify S. haematobium infections. Prevalence, infection intensity, relative prevalence reduction and egg reduction rates were calculated for schistosomiasis and STHs. Cohen's Kappa co-efficient was used to assess agreement between RDTs and microscopy. Chi-square or Fisher's exact test was used to compare WASH indicators in WASH-supported and WASH-unsupported schools. Overall, 17,880 schoolchildren (599 schools) and 6,461 schoolchildren (214 schools) participated in the schistosomiasis and STH surveys, respectively. Prevalence of any schistosomiasis in Huambo was 29.6%, Uige 35.4%, and Zaire 28.2%. Relative reduction in schistosomiasis prevalence from 2014 for Huambo was 18.8% (95% confidence interval (CI) 8.6, 29.0), Uige -92.3% (95%CI -162.2, -58.3), and Zaire -14.0% (95%CI -48.6, 20.6). Prevalence of any STH in Huambo was 16.3%, Uige 65.1%, and Zaire 28.2%. Relative reduction in STH prevalence for Huambo was -28.4% (95%CI -92.1, 35.2), Uige -10.7% (95%CI -30.2, 8.8), and Zaire -20.9% (95%CI -79.5, 37.8). A higher proportion of WASH-supported schools had improved water sources, and toilet and handwashing facilities compared to WASH-unsupported schools. The limited impact this school program has had in controlling schistosomiasis and STHs identifies the need for a comprehensive understanding of individual, community, and environmental factors associated with transmission, and consideration for a community-wide control program.

First person – Arthur Lensen and Margarida C. Gomes

ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Disease Models & Mechanisms, helping researchers promote themselves alongside their papers. Arthur Lensen and Margarida C. Gomes are co-first authors on ‘ An automated microscopy workflow to study Shigella–neutrophil interactions and antibiotic efficacy in vivo’, published in DMM. Arthur conducted the research described in this article while an MSc student in Serge Mostowy's lab at the London School of Hygiene and Tropical Medicine, UK. He is now a PhD student in the lab of Jost Enninga at Institut Pasteur, Paris, France, investigating host-pathogen interactions at the cellular and molecular level. Margarida is a research fellow in Serge Mostowy's lab at the London School of Hygiene and Tropical Medicine, UK, and works with the zebrafish infection model to study host-pathogen interactions, focusing on trained innate immunity.

Building an Evidence Base for the Protection and Support of Breastfeeding: An Interview With Adriano Cattaneo.

Adriano Cattaneo holds an MD degree from the University of Padua, Italy, and an MSc from the London School of Hygiene and Tropical Medicine. He spent most of his professional career in low-income countries, including 4 years as medical officer with the World Health Organization (WHO) in Geneva. After returning to Italy, he worked for 20 years as an epidemiologist at the Unit for Health Services Research and International Health, the Institute for Maternal and Child Health (IRCCS Burlo Garofolo) in Trieste, a WHO Collaborating Centre for Maternal and Child Health. He is the author of more than 220 publications in scientific journals and books, more than 100 of which are in peer reviewed journals. He has been affiliated with International Baby Food Action Network (IBFAN) in Italy since it was created in 2001. As project coordinator of two European Union funded projects, he played an important role in the development of the document Protection, Promotion and Support of Breastfeeding in Europe: A Blueprint for Action, a tool tested and used for the development of national breastfeeding policies and programs. He retired in 2014.

Editorial introductions.

Editorial introductions.

Tribute to Ernie Gould

Tribute to Ernie Gould

Preferences for accessing sexual health services among middle-aged and older adults in the UK: a study protocol for a discrete choice experiment using mixed methods

IntroductionSexual health is essential for general health and well-being. Sexual health services for middle-aged and older adults are not prioritised and optimising available services for this population is often overlooked....

Hand hygiene and water quality assessment in schools of Muthanna province, Southern Iraq.

The severe drought and prolonged heat waves in Iraq have adversely affected the water quality supplied to public facilities. Schools are among the most affected facilities by water scarcity. This work aims to evaluate the level of students' hand hygiene, and the quality of municipal (MW) and drinking water (DW) in some schools of Al-Muthanna Province, Iraq. Between October 2021 and June 2022, a total of 324 water samples from 162 schools and 2,430 hand swabs (HSs) from 1,620 students (1,080 males and 540 females) were collected. Some physicochemical standards of water were assessed besides investigating faecal contamination in water and students' hands using Escherichia coli as an indicator. All MW samples were faecally contaminated with poor standards of pH, turbidity, total dissolved solids, color, and chlorine. Despite the good physicochemical standards of all DW samples, E. coli was observed in 12% of samples. Hand hygiene levels dropped by 2.5-fold within a few hours after school entry compared to early-morning levels (before school entry). Male students were 1.5- and 1.7-fold more prone to hand contamination than female students either inside or outside school, respectively. An increasing chlorine tolerance by E. coli was observed in water samples with turbidity > 5 NTU and pH > 8. The students' hand hygiene level decreases within a few hours of entering school, particularly among male students. Residual-free chlorine < 0.5 mg/L with high turbidity and alkalinity in water is insufficient for 100% prevention of E. coli contamination.