Dataset Information

Development of an educational cartoon to prevent worm infections in Chinese schoolchildren.

ABSTRACT:

Background

With more than two billion people infected worldwide, soil-transmitted helminths (STH) are the most widespread infections. To date, STH control efforts rely predominantly on recurrent mass drug administration (MDA), which does not prevent reinfection. Additional public health measures including novel health educational tools are required for more sustained integrated control of STH. We describe the development of an educational cartoon video (The Magic Glasses) targeting STH infections in Chinese schoolchildren and its pilot testing in China.We applied an extensive community-based mixed methods approach involving input from the target group of 9-10 year old schoolchildren and key informants, such as teachers, doctors and parents, in order to identify potential STH infection risks in the study area and to formulate key messages for the cartoon. The development of the educational cartoon included three major steps: formative research, production, and pilot testing and revision.

Results

We found that most adults and approximately 50% of the schoolchildren were aware of roundworm (Ascaris) infection, but knowledge of transmission, prevention and treatment of STH was poor. Observations in the study area showed that unhygienic food practices, such as eating raw and unwashed fruit or playing in vegetable gardens previously fertilised with human faeces, posed major STH infection risks.

Conclusions

It was crucial to assess the intellectual, emotional, social and cultural background of the target population prior to video production in order to integrate the key messages of the cartoon into everyday situations. Overall, our strategy for the development of the cartoon and its incorporation into a health education package proved successful, and we provide a summary of recommendations for the development of future educational videos based on our experiences in China.

SUBMITTER: Bieri FA

PROVIDER: S-EPMC4177148 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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Publications

Development of an educational cartoon to prevent worm infections in Chinese schoolchildren.

Bieri Franziska A FA Yuan Li-Ping LP Li Yue-Sheng YS He Yong-Kang YK Bedford Andrew A Li Robert S RS Guo Feng-Ying FY Li Sheng-Ming SM Williams Gail M GM McManus Donald P DP Raso Giovanna G Gray Darren J DJ

Infectious diseases of poverty 20131202 1

<h4>Background</h4>With more than two billion people infected worldwide, soil-transmitted helminths (STH) are the most widespread infections. To date, STH control efforts rely predominantly on recurrent mass drug administration (MDA), which does not prevent reinfection. Additional public health measures including novel health educational tools are required for more sustained integrated control of STH. We describe the development of an educational cartoon video (The Magic Glasses) targeting STH i ...[more]

PMID: 24289667

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Project description:ImportanceFew studies have reported the association of economic growth with trends of visual impairment in schoolchildren in China or elsewhere.ObjectivesTo describe 30-year trends and patterns in visual impairment in China and to explore the association between visual impairment and economic development.Design, setting, and participantsIn this time series analysis of 7 successive cross-sectional surveys from 1985 to 2014, a total of 1 951 084 schoolchildren aged 7 to 18 years from all provinces and autonomous regions of mainland China, excluding Tibet, were studied. In 1985, the survey was conducted between March to June; In 1991-2014, the surveys were conducted between September and November. Data analysis was performed from April 1, 2018, to January 31, 2019.ExposuresThe province-level gross domestic product (GDP) per capita was extracted from the China Statistical Yearbook.Main outcomes and measuresVisual impairment, defined as unaided distance visual acuity of worse than 6/7.5 (20/25 Snellen equivalent), and moderate to severe visual impairment, defined as unaided distance visual acuity of worse than 6/18 (20/63 Snellen equivalent), in the worse eye.ResultsA total of 1 951 084 participants (mean [SD] age, 12.6 [3.4] years; 50.5% male) were included in the analysis. Among students aged 7 to 18 years, the prevalence of visual impairment increased from 23.7% (95% CI, 23.6%-23.8%) in 1985 to 35.1% (95% CI, 34.9%-35.3%) in 1995 to 55.0% (95% CI, 54.8%-55.3%) in 2014. In 2014, the prevalence was higher among girls (58.3%; 95% CI, 54.8%-55.3%) vs boys (51.8%; 95% CI, 51.5%-52.1%) (prevalence ratio [PR] girls vs boys, 1.12; 95% CI, 1.11-1.13) and among students living in urban (59.9%; 95% CI, 59.6%-60.2%) vs rural (50.2%; 95% CI, 49.9%-50.5%) areas (PR urban vs rural, 1.17; 95% CI, 1.16-1.18), although a more rapid relative increase in prevalence occurred in rural areas (15.3% in 1985 to 50.2% in 2014) than in urban areas (31.5% in 1985 to 59.9% in 2014). From 1995 to 2014, the GDP in China increased from $1263 to $7594 (in 2014 US$ constant price). After demographic characteristics (cluster effect of school, age, sex, urban vs rural location, and relative socioeconomic status within province) were adjusted for, the regression model revealed that every 100% increase in GDP was associated with a 20% (PR, 1.20; 95% CI, 1.20-1.21) increase in the relative risk of visual impairment and a 27% (PR, 1.27; 95% CI, 1.26-1.27) increase in the relative risk of moderate to severe visual impairment. The association was stronger in male (PR, 1.22; 95% CI, 1.21-1.23 for male [as reference] vs 1.19; 95% CI, 1.18-1.19 for female; P < .001), rural (PR, 1.32; 95% CI, 1.31-1.33 for rural [as reference] vs 1.12; 95% CI, 1.12,-1.33 for urban; P < .001), and younger age groups (PR, 1.27; 95% CI, 1.24-1.29 for 7-9 years of age [as reference] vs 1.34; 95% CI, 1.32-1.36 for 10-12 years of age; P < .001; 1.21; 95% CI, 1.20-1.22 for 13-15 years of age; P < .001; and 1.12; 95% CI, 1.11,-1.13 for 16-18 years of age; P < .001).Conclusions and relevanceThe rapid increase of visual impairment prevalence and the association between GDP and visual impairment over time suggest that further exacerbation of childhood visual impairment may occur as economic development continues in China.

Project description:BackgroundSoil-transmitted helminths (STH) cause substantial disease and disability globally. Health education has proven complementary to school-based drug administration programs for STH control. We determined the generalizability of the impact of "The Magic Glasses" health education package for STH prevention in schoolchildren in Laguna province, the Philippines, having previously shown its positive impact in China.MethodsWe conducted a cluster-randomised controlled trial, in schoolchildren, aged 9-10 years, across 40 schools over one year. Schools were randomly assigned either to the "Magic Glasses Philippines" health education intervention package (consisting of a cartoon video, classroom discussions, drawing and essay competition) complementing the standard health education activities of the Philippines Departments of Health and Education, or to a control group, which involved only the standard health education activities. The primary trial outcomes were the proportion of STH infected schoolchildren and their knowledge, attitude and behaviour of STH assessed in both groups at baseline and through two follow-up surveys undertaken immediately prior to the semi-annual national mass administration of albendazole. The outcomes between the study arms were compared using generalized estimating equation models, accounting for clustering at the school level. The trial is registered with Australian New Zealand Clinical Trials Registry number: ACTRN12616000508471.FindingsAt follow-up assessments, the mean knowledge and behaviour scores in the intervention group were, respectively, 5·3 (95% confidence interval [CI]:4·2-6·5; p=<0.001) and 1·1 (95% CI: 0·4-1·7; p=0.002) percentage points higher than the control group. There was no overall effect on helminth infections (any STH; adjusted odds ratio [aOR]:1·0; 95% CI: 0·8-1·3; p=0·856), Ascaris lumbricoides; aOR:1·0; 95% CI: 0·7-1·6; p=0·894, or Trichuris trichiura; aOR:1·7; 95% CI: 0·9-1·6; p=0·315) but sub-group analysis showed a 60% reduction in the odds of any STH infection resulting from the "Magic Glasses" intervention in schools with a baseline prevalence ≤15% (aOR: 0·4; 95% CI: 0·2-0·7; p=0·001).InterpretationThe health-education package demonstrated a modest but statistically significant impact on the students' overall STH knowledge and changes in their behaviour but was only effective in preventing STH infections in intervention schools where the baseline prevalence was ≤15%.FundingNational Health and Medical Research Council, Australia, and the UBS-Optimus Foundation, Switzerland.

Project description:ImportanceDuring the outbreak of COVID-19, outdoor activities were limited and digital learning increased. Concerns have arisen regarding the impact of these environmental changes on the development of myopia.ObjectiveTo investigate changes in the development of myopia in young Chinese schoolchildren during the outbreak of COVID-19.Design, setting, and participantsIn this observational study, 2 groups of students from 12 primary schools in Guangzhou, China, were prospectively enrolled and monitored from grade 2 to grade 3. Comparisons between the exposure and nonexposure groups were made to evaluate any association between environmental changes during the COVID-19 outbreak period and development of myopia. The exposure group received complete eye examinations in November and December 2019 and November and December 2020. The nonexposure group received examinations in November and December 2018 and November and December 2019.Main outcomes and measuresChanges in cycloplegic spherical equivalent refraction (SER), axial length (AL) elongation, and myopia incidence from grade 2 to grade 3.ResultsAmong the 2679 eligible students in grade 2 (mean [SD] age, 7.76 [0.32] years; 1422 [53.1%] male), 2114 (1060 in the nonexposure group and 1054 in the exposure group) were reexamined in grade 3. Compared with the period from November and December 2018 to November and December 2019, the shift of SER, AL elongation, and myopia incidence from grade 2 to grade 3 from November and December 2019 to November and December 2020 was 0.36 D greater (95% CI, 0.32-0.41; P < .001), 0.08 mm faster (95% CI, 0.06-0.10; P < .001), and 7.9% higher (95% CI, 5.1%-10.6%; P < .001), respectively. In grade 3 students, the prevalence of myopia increased from 13.3% (141 of 1060 students) in November and December 2019 to 20.8% (219 of 1054 students) in November and December 2020 (difference [95% CI], 7.5% [4.3-10.7]; P < .001); the proportion of children without myopia and with SER greater than -0.50 D and less than or equal to +0.50 D increased from 31.1% (286 of 919 students) to 49.0% (409 of 835 students) (difference [95% CI], 17.9% [13.3-22.4]; P < .001).Conclusions and relevanceIn this study, development of myopia increased during the COVID-19 outbreak period in young schoolchildren in China. Consequently, myopia prevalence and the proportion of children without myopia who were at risk of developing myopia increased. Future studies are needed to investigate long-term changes in myopia development after the COVID-19 pandemic.

Project description:BackgroundSoil-transmitted helminth (STH) infections are still prevalent among schoolchildren in the Philippines. We evaluated the risk factors associated with STH and the relationship between STH and nutritional indices among schoolchildren aged 9-10 years in Laguna province, the Philippines.MethodsWe used the baseline data from 40 schools enrolled in a randomised controlled trial of the Magic Glasses Philippines health education package. Data on demographic and socio-economic variables, and STH related knowledge, attitudes and practices, were obtained through a questionnaire. Stool samples were collected and assessed for STH egg presence using the Kato-Katz technique. Haemoglobin levels and height and weight of study participants were also determined. The generalized estimating equations approach was used to construct logistic regression models to assess STH-associated risk factors, and the association between any STH infection and anaemia, child stunting, wasting and being underweight. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000508471).FindingsAmong 1,689 schoolchildren, the prevalence of any STH was 23%. The prevalence of anaemia, stunting, being underweight and wasting was 13%, 20.2%, 19% and 9.5%, respectively. Age, socio-economic status, rural/urban classification of schools and knowledge of STH were significant risk factors for acquiring a STH infection. Moreover, infections with any STH were significantly associated with stunting (P = <0.001) and being underweight (P = <0.003), but not wasting (P = 0.375) or anaemia (P = 0.462) after controlling for confounding covariates.ConclusionThe study findings emphasise the need for sustainable deworming in tandem with other measures such as the provision of health education, improvements in sanitation and hygiene, and nutritional programs in order to control STH infections and improve morbidity outcomes in schoolchildren.Trial registrationAustralian New Zealand Clinical Trials Registry (ACTRN12616000508471).

Project description:BackgroundNeurodevelopmental conditions commonly coexist in children, but compared to adults, childhood multimorbidity attracts less attention in research and clinical practice. We previously reported that children treated for attention deficit hyperactivity disorder (ADHD) and depression have more school absences and exclusions, additional support needs, poorer attainment, and increased unemployment. They are also more likely to have coexisting conditions, including autism and intellectual disability. We investigated prevalence of neurodevelopmental multimorbidity (≥2 conditions) among Scottish schoolchildren and their educational outcomes compared to peers.Methods and findingsWe retrospectively linked 6 Scotland-wide databases to analyse 766,244 children (390,290 [50.9%] boys; 375,954 [49.1%] girls) aged 4 to 19 years (mean = 10.9) attending Scottish schools between 2009 and 2013. Children were distributed across all deprivation quintiles (most to least deprived: 22.7%, 20.1%, 19.3%, 19.5%, 18.4%). The majority (96.2%) were white ethnicity. We ascertained autism spectrum disorder (ASD) and intellectual disabilities from records of additional support needs and ADHD and depression through relevant encashed prescriptions. We identified neurodevelopmental multimorbidity (≥2 of these conditions) in 4,789 (0.6%) children, with ASD and intellectual disability the most common combination. On adjusting for sociodemographic (sex, age, ethnicity, deprivation) and maternity (maternal age, maternal smoking, sex-gestation-specific birth weight centile, gestational age, 5-minute Apgar score, mode of delivery, parity) factors, multimorbidity was associated with increased school absenteeism and exclusion, unemployment, and poorer exam attainment. Significant dose relationships were evident between number of conditions (0, 1, ≥2) and the last 3 outcomes. Compared to children with no conditions, children with 1 condition, and children with 2 or more conditions, had more absenteeism (1 condition adjusted incidence rate ratio [IRR] 1.28, 95% CI 1.27-1.30, p < 0.001 and 2 or more conditions adjusted IRR 1.23, 95% CI 1.20-1.28, p < 0.001), greater exclusion (adjusted IRR 2.37, 95% CI 2.25-2.48, p < 0.001 and adjusted IRR 3.04, 95% CI 2.74-3.38, p < 0.001), poorer attainment (adjusted odds ratio [OR] 3.92, 95% CI 3.63-4.23, p < 0.001 and adjusted OR 12.07, 95% CI 9.15-15.94, p < 0.001), and increased unemployment (adjusted OR 1.57, 95% CI 1.49-1.66, p < 0.001 and adjusted OR 2.11, 95% CI 1.83-2.45, p < 0.001). Associations remained after further adjustment for comorbid physical conditions and additional support needs. Coexisting depression was the strongest driver of absenteeism and coexisting ADHD the strongest driver of exclusion. Absence of formal primary care diagnoses was a limitation since ascertaining depression and ADHD from prescriptions omitted affected children receiving alternative or no treatment and some antidepressants can be prescribed for other indications.ConclusionsStructuring clinical practice and training around single conditions may disadvantage children with neurodevelopmental multimorbidity, who we observed had significantly poorer educational outcomes compared to children with 1 condition and no conditions.

Dataset Information

Development of an educational cartoon to prevent worm infections in Chinese schoolchildren.

Background

Results

Conclusions

Publications

Development of an educational cartoon to prevent worm infections in Chinese schoolchildren.

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