Information, Education, Communication (IEC) and parasite infections in children. A longitudinal effectivity study in public primary schools in the Central Region of Togo, West Africa

Abstract

The present study is based on "Hygiene and School Health" project aiming at strengthening the capacities of school children aged 5 to 15 years to take better care of their health, and at improving the physical environment of public primary schools. For this, in the central region of Togo 106 schools were identified in semi-urban and rural environment. Parasitological surveys and analyzes, de-worming campaigns and health education (IEC) were performed for several years in the study group (EPP-IEC), while the control group (EPP-Plan1) had not benefited from these measures. For the information education and communication (IEC) courses, information materials (posters, leaflets, manuals) were developed for teachers and school children and in parallel collected stool and urine samples were analyzed for the presence of intestinal and intravascular parasites and schistosomiasis using urine sedimentation and the Kato-Katz methodology and deworming campaigns were performed. The IEC materials contained essential information to understand pathogens, their transmission, the diseases they cause, prevention, vaccination and important aspects of personal and school based hygiene. A questionnaire was applied to assess school children’s knowledge on health and school hygiene issues. At the beginning of the study hookworm and schistosomiasis infection intensities were high (above 1000 eggs/g stool and >300 eggs/10ml urine). At year 7 post intervention, the mean infection intensities decreased significantly in treated children. Initially, in the study group 59.3% (n=755) and 37.9% (n=627) were positive for hookworm and schistosomiasis. Following de-worming and repeated IEC and after years, the prevalence of hookworm infection and urinary schistosomiasis in EPP-IEC group decreased to 17.34% (year 5), 12.62% (year 6) and 25.40% (year 7), and to 9.36% (year 5), 19.70% (year 6), 10.85% (year 7) for urinary schistosomiasis. At the beginning of the study, the number of known diseases was n=3, the knowledge and purpose on vaccination was n=2, the understanding for hygiene measures was low (n=1). In all aspects mentioned and after IEC application for several years a significant larger knowledge scores were present and measurable by questionnaire in the study group. The comparison of knowledge scores in health and school hygiene in EPP-IEC group and EPP-Plan1 disclosed significant difference in most of the questionnaire aspects. Strong negative correlations were also seen for associations of knowledge scores with intestinal helminth infection levels. These dependencies showed that the better school children knowledge on health and hygiene aspects, the less parasite infections will be present in schools. The results from the present study indicate that education from age 5-15 years will improve and augment knowledge on parasitic diseases and hygiene, and such early education (IEC in school children) has a huge impact on the prevention of these diseases.