PDF(Pubmed)
Abstract：
BACKGROUND: Soil-transmitted helminths (STH) cause substantial disease and disability globally. Health education has proven complementary to school-based drug administration programs for STH control. We determined the generalizability of the impact of \"The Magic Glasses\" health education package for STH prevention in schoolchildren in Laguna province, the Philippines, having previously shown its positive impact in China.
METHODS: We conducted a cluster-randomised controlled trial, in schoolchildren, aged 9-10 years, across 40 schools over one year. Schools were randomly assigned either to the \"Magic Glasses Philippines\" health education intervention package (consisting of a cartoon video, classroom discussions, drawing and essay competition) complementing the standard health education activities of the Philippines Departments of Health and Education, or to a control group, which involved only the standard health education activities. The primary trial outcomes were the proportion of STH infected schoolchildren and their knowledge, attitude and behaviour of STH assessed in both groups at baseline and through two follow-up surveys undertaken immediately prior to the semi-annual national mass administration of albendazole. The outcomes between the study arms were compared using generalized estimating equation models, accounting for clustering at the school level. The trial is registered with Australian New Zealand Clinical Trials Registry number: ACTRN12616000508471.
RESULTS: At follow-up assessments, the mean knowledge and behaviour scores in the intervention group were, respectively, 5·3 (95% confidence interval [CI]:4·2-6·5; p=<0.001) and 1·1 (95% CI: 0·4-1·7; p=0.002) percentage points higher than the control group. There was no overall effect on helminth infections (any STH; adjusted odds ratio [aOR]:1·0; 95% CI: 0·8-1·3; p=0·856), Ascaris lumbricoides; aOR:1·0; 95% CI: 0·7-1·6; p=0·894, or Trichuris trichiura; aOR:1·7; 95% CI: 0·9-1·6; p=0·315) but sub-group analysis showed a 60% reduction in the odds of any STH infection resulting from the \"Magic Glasses\" intervention in schools with a baseline prevalence ≤15% (aOR: 0·4; 95% CI: 0·2-0·7; p=0·001).
CONCLUSIONS: The health-education package demonstrated a modest but statistically significant impact on the students\' overall STH knowledge and changes in their behaviour but was only effective in preventing STH infections in intervention schools where the baseline prevalence was ≤15%.
BACKGROUND: National Health and Medical Research Council, Australia, and the UBS-Optimus Foundation, Switzerland.
METHODS: We conducted a cluster-randomised controlled trial, in schoolchildren, aged 9-10 years, across 40 schools over one year. Schools were randomly assigned either to the \"Magic Glasses Philippines\" health education intervention package (consisting of a cartoon video, classroom discussions, drawing and essay competition) complementing the standard health education activities of the Philippines Departments of Health and Education, or to a control group, which involved only the standard health education activities. The primary trial outcomes were the proportion of STH infected schoolchildren and their knowledge, attitude and behaviour of STH assessed in both groups at baseline and through two follow-up surveys undertaken immediately prior to the semi-annual national mass administration of albendazole. The outcomes between the study arms were compared using generalized estimating equation models, accounting for clustering at the school level. The trial is registered with Australian New Zealand Clinical Trials Registry number: ACTRN12616000508471.
RESULTS: At follow-up assessments, the mean knowledge and behaviour scores in the intervention group were, respectively, 5·3 (95% confidence interval [CI]:4·2-6·5; p=<0.001) and 1·1 (95% CI: 0·4-1·7; p=0.002) percentage points higher than the control group. There was no overall effect on helminth infections (any STH; adjusted odds ratio [aOR]:1·0; 95% CI: 0·8-1·3; p=0·856), Ascaris lumbricoides; aOR:1·0; 95% CI: 0·7-1·6; p=0·894, or Trichuris trichiura; aOR:1·7; 95% CI: 0·9-1·6; p=0·315) but sub-group analysis showed a 60% reduction in the odds of any STH infection resulting from the \"Magic Glasses\" intervention in schools with a baseline prevalence ≤15% (aOR: 0·4; 95% CI: 0·2-0·7; p=0·001).
CONCLUSIONS: The health-education package demonstrated a modest but statistically significant impact on the students\' overall STH knowledge and changes in their behaviour but was only effective in preventing STH infections in intervention schools where the baseline prevalence was ≤15%.
BACKGROUND: National Health and Medical Research Council, Australia, and the UBS-Optimus Foundation, Switzerland.
摘要：
背景：土壤传播的蠕虫（STH）在全球范围内引起大量疾病和残疾。事实证明，健康教育是对学校控制STH药物管理计划的补充。我们确定了“魔术眼镜”健康教育包对拉古纳省学童预防STH的影响的普遍性，菲律宾,此前曾在中国表现出积极影响。
方法：我们进行了一项集群随机对照试验，在学童中，9-10岁,超过一年的40所学校。学校被随机分配到“菲律宾魔术眼镜”健康教育干预包（由卡通视频组成，课堂讨论,绘画和论文比赛）补充菲律宾卫生和教育部的标准健康教育活动，或控制组，只涉及标准的健康教育活动。主要试验结果是STH感染学童的比例和他们的知识，在基线时以及在每半年对阿苯达唑进行全国大规模管理之前进行的两次后续调查中，对两组的STH的态度和行为进行了评估。使用广义估计方程模型比较了研究组之间的结果，考虑到学校层面的集群。该试验在澳大利亚新西兰临床试验登记号：ACTRN12616000508471注册。
结果：在后续评估中，干预组的平均知识和行为得分为，分别,5·3（95％置信区间[CI]：4·2-6·5；p=<0.001）和1·1（95％CI：0·4-1·7；p=0.002）个百分点比对照组高。对蠕虫感染没有总体影响（任何STH；调整后的比值比[aOR]：1·0；95％CI：0·8-1·3；p=0·856），蛔虫；aOR：1·0；95％CI：0·7-1·6；p=0·894，或Trichuristrichiura；aOR：1·7；95％CI：0·9-1·6；p=0·315），但亚组分析显示，由于“0·0·0·0·0·0·0·0·0·0·0·0·0·
结论：健康教育计划对学生的整体STH知识和行为变化有适度但具有统计学意义的影响，但仅在基线患病率≤15%的干预学校中有效预防STH感染。
背景：国家卫生与医学研究委员会，澳大利亚,瑞银擎天柱基金会,瑞士。
方法：我们进行了一项集群随机对照试验，在学童中，9-10岁,超过一年的40所学校。学校被随机分配到“菲律宾魔术眼镜”健康教育干预包（由卡通视频组成，课堂讨论,绘画和论文比赛）补充菲律宾卫生和教育部的标准健康教育活动，或控制组，只涉及标准的健康教育活动。主要试验结果是STH感染学童的比例和他们的知识，在基线时以及在每半年对阿苯达唑进行全国大规模管理之前进行的两次后续调查中，对两组的STH的态度和行为进行了评估。使用广义估计方程模型比较了研究组之间的结果，考虑到学校层面的集群。该试验在澳大利亚新西兰临床试验登记号：ACTRN12616000508471注册。
结果：在后续评估中，干预组的平均知识和行为得分为，分别,5·3（95％置信区间[CI]：4·2-6·5；p=<0.001）和1·1（95％CI：0·4-1·7；p=0.002）个百分点比对照组高。对蠕虫感染没有总体影响（任何STH；调整后的比值比[aOR]：1·0；95％CI：0·8-1·3；p=0·856），蛔虫；aOR：1·0；95％CI：0·7-1·6；p=0·894，或Trichuristrichiura；aOR：1·7；95％CI：0·9-1·6；p=0·315），但亚组分析显示，由于“0·0·0·0·0·0·0·0·0·0·0·0·0·
结论：健康教育计划对学生的整体STH知识和行为变化有适度但具有统计学意义的影响，但仅在基线患病率≤15%的干预学校中有效预防STH感染。
背景：国家卫生与医学研究委员会，澳大利亚,瑞银擎天柱基金会,瑞士。
