title: Effects of a post-deworming health hygiene education intervention on absenteeism in school-age children of the Peruvian Amazon.
abstract: Soil-transmitted helminth (STH) infections are a leading cause of disability and disease burden in school-age children of worm-endemic regions. Their effect on school absenteeism, however, remains unclear. The World Health Organization currently recommends delivering mass deworming and health hygiene education through school-based programs, in an effort to control STH-related morbidity. In this cluster-RCT, the impact of a health hygiene education intervention on absenteeism was measured. From April to June 2010, all Grade 5 students at 18 schools in a worm-endemic region of the Peruvian Amazon were dewormed. Immediately following deworming, nine schools were randomly assigned to the intervention arm of the trial using a matched-pair design. The Grade 5 students attending intervention schools (N = 517) received four months of health hygiene education aimed at increasing knowledge of STH prevention. Grade 5 students from the other nine schools (N = 571) served as controls. Absenteeism was measured daily through teachers' attendance logs. After four months of follow-up, overall absenteeism rates at intervention and control schools were not statistically significantly different. However, post-trial non-randomized analyses have shown that students with moderate-to-heavy Ascaris infections and light hookworm infections four months after deworming had, respectively, missed 2.4% (95% CI: 0.1%, 4.7%) and 4.6% (95% CI: 1.9%, 7.4%) more schooldays during the follow-up period than their uninfected counterparts. These results provide empirical evidence of a direct effect of STH infections on absenteeism in school-age children.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
authors.forename: François L
authors.initials: FL
authors.lastname: Thériault
authors.affiliation: Department of Global Health & Population, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Maheu-Giroux
authors.affiliation: Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec.
authors.forename: Brittany
authors.initials: B
authors.lastname: Blouin
authors.affiliation: Asociacíon Civil Selva Amazónica, Iquitos, Perù
authors.forename: Martin
authors.initials: M
authors.lastname: Casapía
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec.
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Gyorkos
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000367:Age Factors; D000818:Animals; D002648:Child; D005260:Female; D006266:Health Education; D006373:Helminthiasis / Q000517:prevention & control*; D006801:Humans; D006920:Hygiene; D008297:Male; D012923:Social Class; D012987:Soil / Q000469:parasitology*; D013334:Students
chemical_list: D012987:Soil