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Integrating face washing into a school-based, handwashing behavior change program to prevent trachoma in Turkana, Kenya

Tidwell, James B., Fergus, Cristin, Gopalakrishnan, Anila, Sheth, Esha, Sidibe, Myriam, Wohlgemuth, Leah, Jain, Avinish and Woods, Geordie (2019) Integrating face washing into a school-based, handwashing behavior change program to prevent trachoma in Turkana, Kenya. American Journal of Tropical Medicine and Hygiene, 101 (4). pp. 767-773. ISSN 0002-9637

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Identification Number: 10.4269/ajtmh.19-0205

Abstract

Trachoma is the leading infectious cause of blindness, and facial cleanliness is associated with reduced odds of trachomatous inflammation and Chlamydia trachomatis infection, but there is little evidence of how to drive this behavior change at scale. We report the results of a program integrating face washing into a school-based handwashing promotion program in Turkana County, Kenya. Children aged 5-15 years participated in an intervention delivered to schools in two phases, along with a third phase receiving the intervention after the evaluation, which served as a control. The primary outcome was the number of face washing events that took place when handwashing occurred, which was measured by a 3-hour structured observation at all 67 schools, and a total of 3,871 handwashing events were observed. Differences in observed in face washing behavior between each phase and the control schools were calculated using logbinomial regression with clustering at the school level, whereas survey responses on knowledge of trachoma transmission and prevention were compared using χ2tests adjusted for clustering at the school level. Face washing during handwashing events was higher in schools after 12 months (59.3%) and 20 months (44.2%) than in control schools (18.7%, P < 0.001). Trachoma knowledge was higher in schools evaluated after 12 months (80%) and 20 months (70%) than in control schools (42%, P < 0.001), and knowledge of some of key preventive behaviors was higher in intervention schools. Integrating face washing messages into school-based handwashing promotion programs increased face washing, which may help to prevent trachoma when combined with other interventions.

Item Type: Article
Official URL: http://www.ajtmh.org/
Additional Information: © 2019 by The American Society of Tropical Medicine and Hygiene
Divisions: Institute of Global Affairs
Government
International Development
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
L Education
R Medicine > RB Pathology
Date Deposited: 21 May 2020 14:21
Last Modified: 20 Oct 2020 07:42
URI: http://eprints.lse.ac.uk/id/eprint/104535

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