Health Education, Schistosomiasis
Conditions
Keywords
Schistosomiasis, CHVs, KAP
Brief summary
The goal of this intervention study is to investigate the level of knowledge, attitudes, and behaviors of students on schistosomiasis in Pemba Island. It aims to test the effectiveness of establishing a widely applicable Community Health Volunteers model in the Zanzibar region and explore the feasibility of promoting this model in other areas of Africa. This study also aims to provide valuable insights and references for global schistosomiasis prevention and control efforts.
Detailed description
The main questions it aims to answer are: Conducting a survey to understand the current knowledge levels, attitudes, and relevant health behaviors of Pemba Island students towards schistosomiasis. Performing qualitative research to analyze the factors influencing students' knowledge, attitudes, and behaviors related to schistosomiasis, as well as observing the facilitators and barriers to conducting health education among student groups, in order to provide a scientific basis for targeted intervention measures. Testing the effectiveness of establishing a widely applicable community health volunteer model in the Zanzibar region and exploring the feasibility of promoting this model in other regions of Africa, thereby providing insights and references for global schistosomiasis prevention and control efforts. Participants will select fourth and fifth grade students from two schools located in high-risk schistosomiasis prevalence areas on Pemba Island, with Kilindi Primary School as the intervention group and Shumba Viamboni or Chambani primary school as the control group from Feb 2024 to Feb 2025. Apart from the KAP survey, urine samples will be collected from students three times at least and the prevalence confirmed to compare the effectiveness of the two groups.
Interventions
BEHAVIORALhealth education
In the intervention group, we provide schistosomiasis health education to students once a month through community health volunteers for a duration of six months. After that, the community health volunteers no longer visit the school for health education until the completion of a one-year follow-up period.
Sponsors
Pemba Ministry of Health Zanzibar
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Intervention model description
This model evaluates the effectiveness of schistosomiasis health education led by community health volunteers by training the volunteers on Pemba Island and having them conduct health education for local students. It also discusses the feasibility of promoting this model in Africa.
Eligibility
Sex/Gender
ALL
Age
7 Years to 15 Years
Healthy volunteers
Yes
Inclusion criteria
* Individuals whose grades fall within the scope of the survey Students who have not received health education intervention on schistosomiasis conducted by community health volunteers Students or parents who agree to sign informed consent and participate in the study Students residing in schistosomiasis-endemic areas
Exclusion criteria
* Students whose grades are not within the scope of the survey Students who have already received health education intervention on schistosomiasis Students or parents who refuse to sign informed consent or participate in the study Students who have been diagnosed with other serious illnesses.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Infection Rate | before the intervention, six months after the intervention, and at the end of the one-year observation period | For biological sample collection, students provided first-morning urine samples (30-50 mL) in sterile, pre-labeled wide-mouth containers under teacher supervision to ensure protocol adherence. Certified laboratory technicians performed standardized filtration and microscopic analysis to detect S. haematobium eggs. All egg counts were initially recorded manually, then entered into a Microsoft Excel database using dual-entry verification to maintain data integrity. Infection intensity classified by WHO criteria (light: 1-49 eggs/10ml urine; heavy: ≥ 50 eggs/10ml urine) |
| Change in Knowledge Scores | before the intervention, six months after the intervention, and at the end of the one-year observation period | Measurement Tool: Schistosomiasis Knowledge Questionnaire Description: This questionnaire assesses the knowledge level of students regarding schistosomiasis. Scale Title: Schistosomiasis Knowledge Questionnaire Range: Minimum value: 0, Maximum value: 10 Interpretation: Higher scores indicate a better understanding of schistosomiasis |
| Attitudes Changes | before the intervention, six months after the intervention, and at the end of the one-year observation period | Measurement Tool: Schistosomiasis Attitudes Questionnaire Description: This questionnaire assesses the attitudes level of students regarding schistosomiasis. Scale Title: Schistosomiasis Attitudes Questionnaire Range: Minimum value: 11, Maximum value: 55 Interpretation: Higher scores indicate more positive attitudes related to schistosomiasis |
| Behaviors Changes | before the intervention, six months after the intervention, and at the end of the one-year observation period | Measurement Tool: Schistosomiasis Behaviors Questionnaire Description: This questionnaire assesses the behaviors level of students regarding schistosomiasis. Scale Title: Schistosomiasis Behaviors Questionnaire Range: Minimum value:10 , Maximum value:30 Interpretation: Higher scores indicate more positive behaviors related to schistosomiasis |
Countries
Tanzania
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| CHVs Intervention Group A group of students who receive schistosomiasis health education intervention led by community health volunteers.
health education: In the intervention group, we provide schistosomiasis health education to students once a month through community health volunteers for a duration of six months. After that, the community health volunteers no longer visit the school for health education until the completion of a one-year follow-up period. | 245 |
| Control A A group of students who do not receive schistosomiasis health education intervention led by community health volunteers, but receive conventional health education intervention. | 295 |
| Control B A group of students who do not receive schistosomiasis health education intervention led by community health volunteers, but receive conventional health education intervention. | 346 |
| Total | 886 |
Baseline characteristics
| Characteristic | CHVs Intervention Group | Control A | Control B | Total |
|---|---|---|---|---|
| Age, Continuous | 11.75 years STANDARD_DEVIATION 1.441 | 11.98 years STANDARD_DEVIATION 1.37 | 11.97 years STANDARD_DEVIATION 1.368 | 11.87 years STANDARD_DEVIATION 1.405 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 245 Participants | 295 Participants | 346 Participants | 886 Participants |
| Sex: Female, Male Female | 145 Participants | 182 Participants | 208 Participants | 535 Participants |
| Sex: Female, Male Male | 100 Participants | 113 Participants | 138 Participants | 351 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 278 | 0 / 324 | 0 / 376 |
| other Total, other adverse events | 33 / 278 | 29 / 324 | 30 / 376 |
| serious Total, serious adverse events | 0 / 278 | 0 / 324 | 0 / 376 |
Outcome results
Primary
Attitudes Changes
Measurement Tool: Schistosomiasis Attitudes Questionnaire Description: This questionnaire assesses the attitudes level of students regarding schistosomiasis. Scale Title: Schistosomiasis Attitudes Questionnaire Range: Minimum value: 11, Maximum value: 55 Interpretation: Higher scores indicate more positive attitudes related to schistosomiasis
Time frame: before the intervention, six months after the intervention, and at the end of the one-year observation period
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CHVs Intervention Group | Attitudes Changes | six months after the intervention（T2） | 41.2 Scores | Standard Deviation 8.66 |
| CHVs Intervention Group | Attitudes Changes | before the intervention（T1） | 38.02 Scores | Standard Deviation 8.49 |
| CHVs Intervention Group | Attitudes Changes | at the end of the one-year observation period（T3） | 43.58 Scores | Standard Deviation 8.95 |
| Control A | Attitudes Changes | six months after the intervention（T2） | 41.24 Scores | Standard Deviation 8.15 |
| Control A | Attitudes Changes | before the intervention（T1） | 39.06 Scores | Standard Deviation 8.96 |
| Control A | Attitudes Changes | at the end of the one-year observation period（T3） | 41.39 Scores | Standard Deviation 8.58 |
| Control B | Attitudes Changes | before the intervention（T1） | 39.37 Scores | Standard Deviation 9.98 |
| Control B | Attitudes Changes | at the end of the one-year observation period（T3） | 41.44 Scores | Standard Deviation 10.68 |
| Control B | Attitudes Changes | six months after the intervention（T2） | 42.55 Scores | Standard Deviation 8.85 |
Primary
Behaviors Changes
Measurement Tool: Schistosomiasis Behaviors Questionnaire Description: This questionnaire assesses the behaviors level of students regarding schistosomiasis. Scale Title: Schistosomiasis Behaviors Questionnaire Range: Minimum value:10 , Maximum value:30 Interpretation: Higher scores indicate more positive behaviors related to schistosomiasis
Time frame: before the intervention, six months after the intervention, and at the end of the one-year observation period
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CHVs Intervention Group | Behaviors Changes | six months after the intervention（T2） | 20.56 Scores | Standard Deviation 2.84 |
| CHVs Intervention Group | Behaviors Changes | before the intervention（T1） | 19.05 Scores | Standard Deviation 2.74 |
| CHVs Intervention Group | Behaviors Changes | at the end of the one-year observation period（T3） | 20.7 Scores | Standard Deviation 2.912 |
| Control A | Behaviors Changes | six months after the intervention（T2） | 20.25 Scores | Standard Deviation 2.64 |
| Control A | Behaviors Changes | before the intervention（T1） | 19.35 Scores | Standard Deviation 2.87 |
| Control A | Behaviors Changes | at the end of the one-year observation period（T3） | 20.14 Scores | Standard Deviation 2.66 |
| Control B | Behaviors Changes | before the intervention（T1） | 19.43 Scores | Standard Deviation 2.62 |
| Control B | Behaviors Changes | at the end of the one-year observation period（T3） | 19.6 Scores | Standard Deviation 2.6 |
| Control B | Behaviors Changes | six months after the intervention（T2） | 19.77 Scores | Standard Deviation 2.59 |
Primary
Change in Infection Rate
For biological sample collection, students provided first-morning urine samples (30-50 mL) in sterile, pre-labeled wide-mouth containers under teacher supervision to ensure protocol adherence. Certified laboratory technicians performed standardized filtration and microscopic analysis to detect S. haematobium eggs. All egg counts were initially recorded manually, then entered into a Microsoft Excel database using dual-entry verification to maintain data integrity. Infection intensity classified by WHO criteria (light: 1-49 eggs/10ml urine; heavy: ≥ 50 eggs/10ml urine)
Time frame: before the intervention, six months after the intervention, and at the end of the one-year observation period
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CHVs Intervention Group | Change in Infection Rate | six months after the intervention（T2） | 6 Number of Participants with S. haematobi |
| CHVs Intervention Group | Change in Infection Rate | baseline(T1) | 47 Number of Participants with S. haematobi |
| CHVs Intervention Group | Change in Infection Rate | at the end of the one-year observation period（T3） | 2 Number of Participants with S. haematobi |
| Control A | Change in Infection Rate | six months after the intervention（T2） | 4 Number of Participants with S. haematobi |
| Control A | Change in Infection Rate | baseline(T1) | 35 Number of Participants with S. haematobi |
| Control A | Change in Infection Rate | at the end of the one-year observation period（T3） | 3 Number of Participants with S. haematobi |
| Control B | Change in Infection Rate | baseline(T1) | 3 Number of Participants with S. haematobi |
| Control B | Change in Infection Rate | at the end of the one-year observation period（T3） | 5 Number of Participants with S. haematobi |
| Control B | Change in Infection Rate | six months after the intervention（T2） | 3 Number of Participants with S. haematobi |
Primary
Change in Knowledge Scores
Measurement Tool: Schistosomiasis Knowledge Questionnaire Description: This questionnaire assesses the knowledge level of students regarding schistosomiasis. Scale Title: Schistosomiasis Knowledge Questionnaire Range: Minimum value: 0, Maximum value: 10 Interpretation: Higher scores indicate a better understanding of schistosomiasis
Time frame: before the intervention, six months after the intervention, and at the end of the one-year observation period
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CHVs Intervention Group | Change in Knowledge Scores | six months after the intervention（T2） | 7.13 Scores | Standard Deviation 1.44 |
| CHVs Intervention Group | Change in Knowledge Scores | before the intervention（T1） | 6.11 Scores | Standard Deviation 1.79 |
| CHVs Intervention Group | Change in Knowledge Scores | at the end of the one-year observation period（T3） | 7.11 Scores | Standard Deviation 1.35 |
| Control A | Change in Knowledge Scores | six months after the intervention（T2） | 6.62 Scores | Standard Deviation 1.32 |
| Control A | Change in Knowledge Scores | before the intervention（T1） | 6.42 Scores | Standard Deviation 1.56 |
| Control A | Change in Knowledge Scores | at the end of the one-year observation period（T3） | 6.56 Scores | Standard Deviation 1.7 |
| Control B | Change in Knowledge Scores | before the intervention（T1） | 6.27 Scores | Standard Deviation 1.47 |
| Control B | Change in Knowledge Scores | at the end of the one-year observation period（T3） | 6.62 Scores | Standard Deviation 1.56 |
| Control B | Change in Knowledge Scores | six months after the intervention（T2） | 7.22 Scores | Standard Deviation 1.23 |