The impact of a school-based hygiene, water quality and sanitation intervention on soil-transmitted helminth reinfection: a cluster-randomized trial

Am J Trop Med Hyg. 2013 Nov;89(5):875-83. doi: 10.4269/ajtmh.13-0237. Epub 2013 Sep 9.

Abstract

We conducted a cluster-randomized trial to assess the impact of a school-based water treatment, hygiene, and sanitation program on reducing infection with soil-transmitted helminths (STHs) after school-based deworming. We assessed infection with STHs at baseline and then at two follow-up rounds 8 and 10 months after deworming. Forty government primary schools in Nyanza Province, Kenya were randomly selected and assigned to intervention or control arms. The intervention reduced reinfection prevalence (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.31-1.00) and egg count (rate ratio [RR] 0.34, CI 0.15-0.75) of Ascaris lumbricoides. We found no evidence of significant intervention effects on the overall prevalence and intensity of Trichuris trichiura, hookworm, or Schistosoma mansoni reinfection. Provision of school-based sanitation, water quality, and hygiene improvements may reduce reinfection of STHs after school-based deworming, but the magnitude of the effects may be sex- and helminth species-specific.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Ascariasis / epidemiology
  • Ascariasis / parasitology
  • Ascariasis / transmission*
  • Ascaris lumbricoides / isolation & purification
  • Child
  • Female
  • Hookworm Infections / epidemiology
  • Hookworm Infections / parasitology
  • Hookworm Infections / transmission*
  • Humans
  • Hygiene / education*
  • Kenya / epidemiology
  • Male
  • Prevalence
  • Sanitation*
  • Schistosoma mansoni / isolation & purification
  • Schistosomiasis / epidemiology
  • Schistosomiasis / parasitology
  • Schistosomiasis / transmission*
  • Schools
  • Soil / parasitology
  • Trichuris / isolation & purification
  • Water Quality*

Substances

  • Soil