Hand hygiene intervention to optimise soil-transmitted helminth infection control among primary school children found to be not effective

1. Among a group of primary school children in Tanzania, a combination intervention aimed at enhancing handwashing had no effect on soil-transmitted helminth infection.

Evidence Rating Level: 1 (Excellent)

Soiled-transmitted helminth (STH) infections are frequent amongst school children in low- and middle-income countries. It represents significant morbidity as it is associated with increased rates of anemia and impaired physical and cognitive development. The aim of the randomised controlled trial was to evaluate the effectiveness of a specialized program in reducing the incidence of these infections. The intervention involved 3 components: health education for children, engagement meeting with parents, and slight modification of the school environment to facilitate handwashing. The trial enrolled 16 primary schools, 8 of which were allocated to the intervention group (n = 4872 students), while the rest were given standard health education (n = 4607 students). The two groups were balanced in terms of sex and students’ age. The study found that 72% of students from the intervention group reported using soap and water to wash their hands at school compared to 39% of students in the control group (adjusted odd’s ratio [aOR] = 3.7, 95% CI = 1.35 to 10.15, p = 0.002). In comparison, 45% of children in the intervention group reported washing their hands with soap and water at home versus 33% of children from the control group (aOR = 1.02, 95% CI = 0.74 to 1.39, p = 0.90). The combined prevalence of Ascaris lumbricoides and Trichuris trichiura infection was 39% in both groups (aOR = 1.19, 95% CI 0.74 to 1.91). Thus, the study concluded that the intervention had a significant effect on improving handwashing amongst children at school. However, there was no difference noted between the groups in terms of handwashing at home. The study predicted that this was likely the primary reason for a lack of difference in infection rates amongst the group, along with other possibilities such as contaminated food and water. Therefore, it provides direction for future studies to focus on evaluating the effectiveness of these factors to reduce infection rates.

Click to read the study in BMC Medicine

Image: PD

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