Impact of health education on soil-transmitted helminth infections in schoolchildren of the Peruvian Amazon: a cluster-randomized controlled trial.

To control soil-transmitted helminth (sth) infections,the world health organization recommends school-based deworming programs with a health hygiene education component. the effect of such health hygiene interventions,however,has not been adequately studied. the objective of the present study was to determine the effectiveness of a health hygiene education intervention on the occurrence of sth re-infection four months post-de-worming. an open-label pair-matched cluster-randomized trial was conducted in grade 5 schoolchildren of 18 primary schools (9 intervention and 9 control) in the peruvian amazon. baseline assessment included interview with a pre-tested questionnaire and collection of single stool specimens that were examined using the single kato-katz thick smear. all schoolchildren were then treated with single-dose albendazole (400 mg). schoolchildren in intervention schools then received 1) an initial one hour in-class activity on health hygiene and sanitation and 30-minute refresher activities every two weeks over four months; and 2) a half-day workshop for teachers and principals,while children in control schools did not. four months later,sth infection was re-assessed in all schools by laboratory technologists blinded to intervention status. from april 21-october 20,2010,a total of 1,089 schoolchildren (518 and 571 from intervention and control schools,respectively) participated in this study. intervention children scored significantly higher on all aspects of a test of sth-related knowledge compared with control children (aor = 18·4; 95% ci: 12·7 to 26·6). the intensity of ascaris lumbricoides infection at follow-up was statistically significantly lower (by 58%) in children in intervention schools compared with children in control schools (airr = 0·42; 95% ci = 0·21 to 0·85). no significant changes in hookworm or trichuris trichiura intensity were observed. a school-based health hygiene education intervention was effective in increasing sth knowledge and in reducing ascaris lumbricoides infection. the benefits of school-based periodic deworming programs are likely to be enhanced when a sustained health hygiene education intervention is integrated into school curricula.