Soil-transmitted Helminth Infections
Conditions
Keywords
soil-transmitted helminths, hookworm, deworming, albendazole, health education, water, sanitation and hygiene, WASH, ethnic Khmer, children, Vietnam, Mekong Delta
Brief summary
This study evaluated whether adding community health education and household hygiene promotion to supervised deworming could improve soil-transmitted helminth (STH) outcomes and related caregiver and household factors among ethnic Khmer children aged 6-10 years in southern Vietnam. The study used a non-randomized controlled before-and-after design in four communes. Two communes received the intervention and two served as controls. Both groups received a single supervised oral dose of albendazole 400 mg at month 3. The intervention group additionally received a 6-month package of community health education sessions, household hygiene guidance visits, and a community handwashing campaign. The primary outcome was STH positivity at 6 months. Secondary outcomes included species-specific STH positivity, caregiver knowledge, attitudes and practices, and observed household hygiene conditions.
Detailed description
This was a non-randomized controlled before-and-after study conducted among ethnic Khmer children and their caregivers in four communes in Ca Mau Province, Vietnam. Communes were selected purposively because of their large ethnic Khmer populations. Two communes were assigned to the intervention condition and two communes to the control condition; allocation was not randomized. Eligible participants were ethnic Khmer children aged 6-10 years who were in good general health at enrollment and their primary caregivers. A total of 704 children were enrolled, including 365 in the intervention group and 339 in the control group. Both study groups received a single supervised oral dose of albendazole 400 mg at month 3. In addition, the intervention group received a 6-month community health education and hygiene promotion package. The package included community education sessions for caregivers and children, household hygiene guidance visits, and a community handwashing campaign. Educational content addressed soil-transmitted helminth transmission, consequences of infection, periodic deworming, handwashing with soap, latrine use, safe water, and footwear. Baseline and 6-month assessments included stool examination for soil-transmitted helminth infection, caregiver knowledge, attitude and practice assessments, and direct observation of selected household hygiene conditions. Stool specimens were examined by direct wet-mount microscopy for Ascaris lumbricoides, Trichuris trichiura, and hookworm. The intervention was intended to improve caregiver knowledge and household hygiene practices and thereby reduce exposure and reinfection following deworming.
Interventions
Albendazole 400 mg administered orally as a single supervised dose at month 3 by health staff.
BEHAVIORALCommunity Health Education and Hygiene Promotion
A 6-month package including at least two community health education sessions for caregivers and children, household hygiene guidance visits during months 2 and 5, and at least one community handwashing campaign. The educational content addressed soil-transmitted helminth transmission, consequences of infection, periodic deworming, handwashing with soap, latrine use, safe water, and footwear.
Sponsors
Can Tho University of Medicine and Pharmacy
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Four communes were included in the study. Two communes were assigned to the intervention condition and two communes to the control condition. Allocation was conducted at the commune level and was not randomized. Participants remained in their assigned study condition throughout the 6-month follow-up.
Eligibility
Sex/Gender
ALL
Age
6 Years to 10 Years
Healthy volunteers
Yes
Inclusion criteria
* Ethnic Khmer children aged 6 to 10 years. * In good general health at enrollment. * Participation with a primary caregiver. * Written informed consent provided by a parent or legal guardian.
Exclusion criteria
* Acute illness at enrollment. * Serious chronic illness at enrollment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Soil-Transmitted Helminth Positivity at 6 Months | 6 months after baseline (approximately 3 months after albendazole administration) | Proportion of children with a stool sample positive for at least one soil-transmitted helminth species, including Ascaris lumbricoides, Trichuris trichiura, or hookworm, as detected by direct wet-mount microscopy. A sample was classified as positive when at least one egg or larva of any of these species was observed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hookworm Positivity at 6 Months | 6 months after baseline | Proportion of children with hookworm eggs or larvae detected in stool by direct wet-mount microscopy. |
| Ascaris lumbricoides Positivity at 6 Months | 6 months after baseline | Proportion of children with Ascaris lumbricoides eggs detected in stool by direct wet-mount microscopy. |
| Trichuris trichiura Positivity at 6 Months | 6 months after baseline | Proportion of children with Trichuris trichiura eggs detected in stool by direct wet-mount microscopy. |
| Persistence of STH Positivity Among Baseline-Positive Children | 6 months after baseline | Proportion of children who were positive for soil-transmitted helminth infection at baseline and remained positive at the 6-month follow-up. |
| New STH Positivity Among Baseline-Negative Children | 6 months after baseline | Proportion of children who were negative for soil-transmitted helminth infection at baseline and were positive at the 6-month follow-up. |
| Caregiver Knowledge Score | Baseline and 6 months | Total caregiver knowledge score ranging from 0 to 21, with higher scores indicating greater knowledge regarding soil-transmitted helminth infection and prevention. |
| Caregiver Attitude Score | Baseline and 6 months | Total caregiver attitude score ranging from 0 to 5, with higher scores indicating more favorable attitudes toward prevention of soil-transmitted helminth infection. |
| Caregiver Practice Score | Baseline and 6 months | Total caregiver practice score ranging from 0 to 7, with higher scores indicating more recommended preventive practices. |
| Presence of a Household Handwashing Place | Baseline and 6 months | Proportion of households with an observed designated handwashing place. |
| Soap Available at the Handwashing Place | Baseline and 6 months | Proportion of households with soap observed at the household handwashing place. |
| Clean Household Surroundings | Baseline and 6 months | Proportion of households with clean surroundings and no visible waste on direct observation. |
Countries
Vietnam
Outcome results
None listed