"The Magic Glasses Philippines": a cluster randomised controlled trial of a health education package for the prevention of intestinal worm infections in schoolchildren.

Autor:	Mationg MLS; Research School of Population Heath, The Australian National University, Canberra, Australia.; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Williams GM; School of Public Health, University of Queensland, Brisbane, Australia., Tallo VL; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Olveda RM; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Aung E; Research School of Population Heath, The Australian National University, Canberra, Australia.; St Vincent's Clinical School, University of New South Wales, Sydney, Australia., Alday P; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Reñosa MD; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Daga CM; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Landicho J; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Demonteverde MP; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Santos ED; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Bravo TA; Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines., Bieri FA; Research School of Population Heath, The Australian National University, Canberra, Australia., Bedford A; Research School of Population Heath, The Australian National University, Canberra, Australia., Li Y; Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia.; Hunan Institute of Parasitic Diseases, World Health Organization Collaborating Centre for Research and Control on Schistosomiasis in Lake Region, Yueyang, China., Clements ACA; Faculty of Health Sciences, Curtin University, Perth, Australia., Steinmann P; Swiss Tropical and Public Health Institute, Basel, Switzerland.; University of Basel, Basel, Switzerland., Halton K; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia., Stewart DE; Research School of Population Heath, The Australian National University, Canberra, Australia.; School of Medicine, Griffith University, Brisbane, Australia., McManus DP; Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia., Gray DJ; Research School of Population Heath, The Australian National University, Canberra, Australia.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Western Pacific [Lancet Reg Health West Pac] 2021 Nov 03; Vol. 18, pp. 100312. Date of Electronic Publication: 2021 Nov 03 (Print Publication: 2022).
DOI:	10.1016/j.lanwpc.2021.100312
Abstrakt:	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. Findings: 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). Interpretation: 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%. Funding: National Health and Medical Research Council, Australia, and the UBS-Optimus Foundation, Switzerland. Competing Interests: All authors declare no competing interests. (© 2021 The Authors.)
Databáze:	MEDLINE
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