title: The impact of a school-based hygiene, water quality and sanitation intervention on soil-transmitted helminth reinfection: a cluster-randomized trial.
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.
authors.affiliation: Emory University, Atlanta, Georgia; London School of Hygiene and Tropical Medicine, London, United Kingdom; Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya; Great Lakes University of Kisumu, Kisumu, Kenya; University of Florida, Gainesville, Florida.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Freeman
authors.forename: Thomas
authors.initials: T
authors.lastname: Clasen
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Brooker
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Akoko
authors.forename: Richard
authors.initials: R
authors.lastname: Rheingans
mesh_terms: D000293:Adolescent; D000818:Animals; D001196:Ascariasis / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission*; D017164:Ascaris lumbricoides / Q000302:isolation & purification; D002648:Child; D005260:Female; D006725:Hookworm Infections / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission*; D006801:Humans; D006920:Hygiene / Q000193:education*; D007630:Kenya / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012499:Sanitation; D012550:Schistosoma mansoni / Q000302:isolation & purification; D012552:Schistosomiasis / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission*; D012574:Schools; D012987:Soil / Q000469:parasitology; D014258:Trichuris / Q000302:isolation & purification; D060753:Water Quality
chemical_list: D012987:Soil
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