Impact of Hand Hygiene Activities on the Prevention of Intestinal Parasitic Infections and Anaemia Among School Children
Condition: Intestinal Parasitic Infections; Anaemia
MeSH terms: Infections; Communicable Diseases; Parasitic Diseases; Intestinal Diseases, Parasitic; Anemia
Study type: Interventional

Summary: 
      Impact exerted by intestinal parasitic infections is much higher in developing countries.
      School-aged children are at higher risk from the burden of disease, because they specially
      have many parasitic infections. The poor health results in deficits in physical and cognitive
      development and educational achievements. Nowadays, there is huge commitment among the global
      community to control intestinal parasitic infections and to improve nutritional status of
      young children in developing countries.

      Large-scale anthelminthic drug administration through vertical control programmes is still
      required for the foreseeable future and is, therefore, recommended by the World Health
      Organization (WHO). However, due to the inevitability of re-infection in endemic areas,
      children need to be treated regularly, and once morbidity control is consolidated, the
      strategy must shift to transmission control emphasising access to clean water and adequate
      sanitation. To lower dependency on 'drug only' approach and to enhance sustainability, from
      the onset of control activities, complementary measures should be implemented, that depend on
      available resources.

      Therefore, the investigators are proposing to undertake a randomised controlled trial to
      assess the impact of simple and easy-to-do hand hygiene intervention packages (hand washing
      with soap and hand finger nail clipping) on intestinal parasitic infection prevalence,
      intensity and re-infection rates and on haemoglobin concentration and anaemia prevalence
      rates among 6-15 years old schoolchildren. Our results will provide solid evidence on if and
      how hand hygiene practice affects infection prevalence and re-infection rates, as well as,
      anaemia prevalence among the highly vulnerable age group.
    

Detailed description: 
      The controlled prospective cohort study will be carried out in Kilte awlaelo wereda, north
      Ethiopia. A total of 216 households with at least one school-aged child (aged 6-15) will be
      randomly selected by systematic random sampling method. Different intervention packages will
      be randomised among households. Intervention activities will be implemented at household
      level, using the selected child within the household as study unit.

      If there are more than one child per randomised household all children will receive the
      intervention, but only two children, selected by simple random selection method, will be
      included in the trial. Selected children will be screened for intestinal parasitosis,
      following acquisition of signed informed consent, and will be recruited for the study after
      treatment.

      Parasite negative children in the respective households will be randomly allocated into
      intervention and control groups. Sequence allocation will be done in a central office by an
      individual who do not know and have no contact with the study sites and households.

      Each intervention and control group will have a fixed number of participants, and will be
      subjected to only one of the study interventions. Children and households in each group will
      be followed-up for 6 months by trained fieldworkers and the investigators according to a
      developed protocol throughout the study period. Parasitological, haemoglobin and
      anthropometric data will be collected at entry and after six months.
    

Intervention name(s): Hand washing with soap and hand finger nail clipping
Intervention type(s): Behavioral
Intervention description(s): Assess the impact of hand washing with soap and nail clipping on child health
Other intervention name(s): Hand washing and finger nails clipping
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Intestinal parasitic infections; Anaemia; School-aged children; Hand washing and nail clipping