Title: Reducing malnutrition and helminthic infectious disease among primary school children by the school nurses: School-based non-randomized study in a developing country Introduction: Globally, malnutrition alone with the infectious disease a widespread problem among primary school (5 to 12 years) children. Infectious diseases such as worm infestations are aggravated with nutritional disorders which most often lead to anemia and several complications. The prevalence of malnutrition and intestinal worm infestation/ helminthic infection is still high and the awareness level of those issues is immensely poor. However, there are limited studies that evaluated the impact of increasing health awareness by the development of the Health Awareness Program for Primary School Children (HAPSC) which is conducted by the experimentally placed school nurse in Bangladesh. Objective: To increase health awareness and knowledge towards reducing malnutrition and intestinal worm infestation by implement and evaluate the impact of the Health Awareness Program for Primary School children (HAPSC) in Bangladesh. Methods: Design: A prospective, open-label, parallel-group (1:1), cluster non-randomization controlled trial (NRCT) Site and sample: School children from four primary schools in the rural areas of North Matlab at Chandpur district at Chittagong division in Bangladesh. Duration: The duration of this study is from August 2021 to March 2024 (32nd months). Outcome variables: Primary: changes in malnutrition among primary school children. Secondary: Evaluate and reduce the prevalence of intestinal worm infestation, increase awareness and knowledge regarding malnutritional and intestinal worm infestation, improvement of health behavior (eating and hygiene), frequency of school absent days, and health-related quality of life. Conclusion: Health education by the health professional in the school setting may be an effective method for improving health behavior, and increasing awareness and knowledge levels about malnutrition and intestinal worm infestation from early childhood.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
604
This interventional study period started from September 2021 up to September 2022 (13 months) by school nurses to implement HAPSC. After completing four to five months of the educational session the school nurse will collect midline follow-up data and the endline data will be collected at the end of the interventional study. In this period a total of nine months (except annual leave) will be considered an interventional education period. The intervention group will receive one educational session per week every month. School nurses will be assigned for each class to provide health education. Each session will be conducted for a maximum of 45 minutes. The community worker will be assigned to assist the school nurse and they will communicate with the child's parents about their child's healthy nutrition and good hygiene practice. The significance of healthy eating and hygiene behavior for the children will be shared with the child's parents or guardians properly.
North South University
Dhaka, Bangladesh
Changes in malnutrition rate among primary school children
The primary outcome will be evaluated by anthropometric health assessment (Body mass index). To calculate BMI, the body weight and height will be used following the BMI formula (BMI = weight (kg) / (height)\^2 (m)\^2) provided by World Health Organization (WHO). Children's nutritional status and BMI-for-age will be measured by comparing the z- scores against the WHO growth reference 2007 tables for 5-19 years. The cut-off values for overweight and obesity are \> + 1SD, \> + 2SD respectively. On the other hand, the cut-off value for thinness is \<- 2SD\>.
Time frame: Baseline, 4th/ 5th month after baseline (Midline) and 12th month after baseline (Endline)
Change of the prevalence of intestinal worm infestation among primary school children
Evaluate by health assessment and laboratory test for helminth ova and the parasite
Time frame: Baseline and 12th month after baseline (Endline)
Change of the children's eating and drinking behavior, and health-related hygiene behavior
Evaluate by using a questionnaire which is developed by the researcher
Time frame: Baseline, 4th/ 5th month after baseline (Midline) and 12th month after baseline (Endline)
Change of the awareness and knowledge regarding malnutrition and intestinal worm infestation
Evaluate by using a questionnaire which is developed by the researcher
Time frame: Baseline, 4th/ 5th month after baseline (Midline) and 12th month after baseline (Endline)
Change of the frequency and number of school absent days among the children
Evaluate by using a questionnaire which is developed by the researcher
Time frame: Baseline, 4th/ 5th month after baseline (Midline) and 12th month after baseline (Endline)
Measuring the changes of Health-related quality of life (HRQoL) of the children
Evaluate by using KIDSCREEN survey form, parents' version
Time frame: Baseline, 4th/ 5th month after baseline (Midline) and 12th month after baseline (Endline)
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