Black RE, Morris SS, Bryce J, 2003. Where and why are 10 million children dying every year? Lancet 361: 2226–2234.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhea: systematic review and meta-analysis. BMJ 334: 782.
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhea risk in the community: a systematic review. Lancet Infect Dis 3: 275–281.
Arnold B, Arana B, Mausezahl D, Hubbard A, Colford JM Jr, 2009. Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala. Int J Epidemiol 38: 1651–1661.
Rosa G, Clasen T, 2010. Estimating the scope of household water treatment in low- and medium-income countries. Am J Trop Med Hyg 82: 289–300.
Luby SP, Mendoza C, Keswick BH, Chiller TM, Hoekstra RM, 2008. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78: 382–387.
Luby SP, Agboatwalla M, Bowen A, Kenah E, Sharker Y, Hoekstra RM, 2009. Difficulties in maintaining improved handwashing behavior, Karachi, Pakistan. Am J Trop Med Hyg 81: 140–145.
Parker AA, Stephenson R, Riley PL, Ombeki S, Komolleh C, Sibley L, Quick R, 2006. Sustained high levels of stored drinking water treatment and retention of hand-washing knowledge in rural Kenyan households following a clinic-based intervention. Epidemiol Infect 134: 1029–1036.
Sheth AN, Russo ET, Menon M, Wannemuehler K, Weinger M, Kudzala AC, Tauzie B, Masuku HD, Msowoya TE, Quick R, 2010. Impact of the integration of water treatment and handwashing incentives with antenatal services on hygiene practices of pregnant women in Malawi. Am J Trop Med Hyg 83: 1315–1321.
Ayi I, Nonaka D, Adjovu JK, Hanafusa S, Jimba M, Bosompem KM, Mizoue T, Takeuchi T, Boakye DA, Kobayashi J, 2010. School-based participatory health education for malaria control in Ghana: engaging children as health messengers. Malar J 9: 98.
Nonaka D, Kobayashi J, Jimba M, Vilaysouk B, Tsukamoto K, Kano S, Phommasack B, Singhasivanon P, Waikagul J, Tateno S, Takeuchi T, 2008. Malaria education from school to community in Oudomxay province, Lao PDR. Parasitol Int 57: 76–82.
Onyango-Ouma W, Aagaard-Hansen J, Jensen BB, 2005. The potential of schoolchildren as health change agents in rural western Kenya. Soc Sci Med 61: 1711–1722.
Blanton E, Ombeki S, Oluoch GO, Mwaki A, Wannemuehler K, Quick R, 2010. Evaluation of the role of school children in the promotion of point-of-use water treatment and handwashing in schools and households–Nyanza Province, Western Kenya, 2007. Am J Trop Med Hyg 82: 664–671.
Migele J, Ombeki S, Ayalo M, Biggerstaff M, Quick R, 2007. Diarrhea prevention in a Kenyan school through the use of a simple safe water and hygiene intervention. Am J Trop Med Hyg 76: 351–353.
O'Reilly CE, Freeman MC, Ravani M, Migele J, Mwaki A, Ayalo M, Ombeki S, Hoekstra RM, Quick R, 2008. The impact of a school-based safe water and hygiene programme on knowledge and practices of students and their parents: Nyanza Province, western Kenya, 2006. Epidemiol Infect 136: 80–91.
Freeman MC, Greene LE, Dreibelbis R, Saboori S, Muga R, Brumback B, Rheingans R, 2012. Assessing the impact of a school-based water treatment, hygiene and sanitation programme on pupil absence in Nyanza Province, Kenya: a cluster-randomized trial. Trop Med Int Health 17: 380–391.
Meadows E, Le Saux N, 2004. A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children. BMC Public Health 4: 50.
CDC, 2007. Baseline data from the Nyando Integrated Child Health and Education Project–Kenya, 2007. MMWR Morb Mortal Wkly Rep 56: 1109–1113.
Kenya National Bureau of Statistics (KNBS), ICF Macro, 2010. Kenya Demographic and Health Survey 2008–09. Calverton, MD: KNBS and ICF Macro.
Suchdev PS, Ruth L, Obure A, Were V, Ochieng C, Ogange L, Owuor M, Ngure F, Quick R, Juliao P, Jung C, Teates K, Cruz K, Jefferds ME, 2010. Monitoring the marketing, distribution, and use of Sprinkles micronutrient powders in rural western Kenya. Food Nutr Bull 31: S168–S178.
Rabie T, Curtis V, 2006. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health 11: 258–267.
UNICEF, 2011. Water, sanitation, and hygiene in schools. Available at: http://www.unicef.org/wash/index_schools.html. Accessed May 18, 2011.
The Global Public-Private Partnership for Handwashing with Soap, 2011. Available at: http://globalhandwashing.org/index.php. Accessed May 19, 2011.
Global Water Challenge, 2011. Available at: http://www.globalwaterchallenge.org/home/. Accessed May 19, 2011.
Freeman MC, Quick RE, Abbott DP, Ogutu P, Rheingans R, 2009. Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya. J Water Health 7: 527–534.
Freeman MC, Clasen T, 2011. Assessing the impact of a school-based safe water intervention on household adoption of point-of-use water treatment practices in southern India. Am J Trop Med Hyg 84: 370–378.
Bowen A, Ma H, Ou J, Billhimer W, Long T, Mintz E, Hoekstra RM, Luby S, 2007. A cluster-randomized controlled trial evaluating the effect of a handwashing-promotion program in Chinese primary schools. Am J Trop Med Hyg 76: 1166–1173.
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School-based hygiene and water treatment programs increase student knowledge, improve hygiene, and decrease absenteeism, however health impact studies of these programs are lacking. We collected baseline information from students in 42 schools in Kenya. We then instituted a curriculum on safe water and hand hygiene and installed water stations in half (“intervention schools”). One year later, we implemented the intervention in remaining schools. Through biweekly student household visits and two annual surveys, we compared the effect of the intervention on hygiene practices and reported student illness. We saw improvement in proper handwashing techniques after the school program was introduced. We observed a decrease in the median percentage of students with acute respiratory illness among those exposed to the program; no decrease in acute diarrhea was seen. Students in this school program exhibited sustained improvement in hygiene knowledge and a decreased risk of respiratory infections after the intervention.
Financial support: Funding was provided by the Centers for Disease Control and Prevention and USAID's Global Health Bureau.
Authors' addresses: Minal K. Patel, Julie R. Harris, Patricia Juliao (c/o Minal Patel), Benjamin Nygren, Robert M. Hoekstra, and Robert Quick, Epidemic Intelligence Service and Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: hgo9@cdc.gov, ggt5@cdc.gov, patricia.d.juliao@gsk.com, ghz8@cdc.gov, rth6@cdc.gov, and rxq1@cdc.gov. Vincent Were, Kenya Medical Research Institute, Nairobi, Kenya, E-mail: vincentwere@yahoo.com. Steve Kola, Ibrahim Sadumah, Sitnah Hamidah Faith, and Ronald Otieno, NICHE Project, Kisumu, Kenya, E-mails: stvkola@yahoo.co.uk, sitnahfaith@yahoo.com, and ronotieno@yahoo.com.
Black RE, Morris SS, Bryce J, 2003. Where and why are 10 million children dying every year? Lancet 361: 2226–2234.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhea: systematic review and meta-analysis. BMJ 334: 782.
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhea risk in the community: a systematic review. Lancet Infect Dis 3: 275–281.
Arnold B, Arana B, Mausezahl D, Hubbard A, Colford JM Jr, 2009. Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala. Int J Epidemiol 38: 1651–1661.
Rosa G, Clasen T, 2010. Estimating the scope of household water treatment in low- and medium-income countries. Am J Trop Med Hyg 82: 289–300.
Luby SP, Mendoza C, Keswick BH, Chiller TM, Hoekstra RM, 2008. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78: 382–387.
Luby SP, Agboatwalla M, Bowen A, Kenah E, Sharker Y, Hoekstra RM, 2009. Difficulties in maintaining improved handwashing behavior, Karachi, Pakistan. Am J Trop Med Hyg 81: 140–145.
Parker AA, Stephenson R, Riley PL, Ombeki S, Komolleh C, Sibley L, Quick R, 2006. Sustained high levels of stored drinking water treatment and retention of hand-washing knowledge in rural Kenyan households following a clinic-based intervention. Epidemiol Infect 134: 1029–1036.
Sheth AN, Russo ET, Menon M, Wannemuehler K, Weinger M, Kudzala AC, Tauzie B, Masuku HD, Msowoya TE, Quick R, 2010. Impact of the integration of water treatment and handwashing incentives with antenatal services on hygiene practices of pregnant women in Malawi. Am J Trop Med Hyg 83: 1315–1321.
Ayi I, Nonaka D, Adjovu JK, Hanafusa S, Jimba M, Bosompem KM, Mizoue T, Takeuchi T, Boakye DA, Kobayashi J, 2010. School-based participatory health education for malaria control in Ghana: engaging children as health messengers. Malar J 9: 98.
Nonaka D, Kobayashi J, Jimba M, Vilaysouk B, Tsukamoto K, Kano S, Phommasack B, Singhasivanon P, Waikagul J, Tateno S, Takeuchi T, 2008. Malaria education from school to community in Oudomxay province, Lao PDR. Parasitol Int 57: 76–82.
Onyango-Ouma W, Aagaard-Hansen J, Jensen BB, 2005. The potential of schoolchildren as health change agents in rural western Kenya. Soc Sci Med 61: 1711–1722.
Blanton E, Ombeki S, Oluoch GO, Mwaki A, Wannemuehler K, Quick R, 2010. Evaluation of the role of school children in the promotion of point-of-use water treatment and handwashing in schools and households–Nyanza Province, Western Kenya, 2007. Am J Trop Med Hyg 82: 664–671.
Migele J, Ombeki S, Ayalo M, Biggerstaff M, Quick R, 2007. Diarrhea prevention in a Kenyan school through the use of a simple safe water and hygiene intervention. Am J Trop Med Hyg 76: 351–353.
O'Reilly CE, Freeman MC, Ravani M, Migele J, Mwaki A, Ayalo M, Ombeki S, Hoekstra RM, Quick R, 2008. The impact of a school-based safe water and hygiene programme on knowledge and practices of students and their parents: Nyanza Province, western Kenya, 2006. Epidemiol Infect 136: 80–91.
Freeman MC, Greene LE, Dreibelbis R, Saboori S, Muga R, Brumback B, Rheingans R, 2012. Assessing the impact of a school-based water treatment, hygiene and sanitation programme on pupil absence in Nyanza Province, Kenya: a cluster-randomized trial. Trop Med Int Health 17: 380–391.
Meadows E, Le Saux N, 2004. A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children. BMC Public Health 4: 50.
CDC, 2007. Baseline data from the Nyando Integrated Child Health and Education Project–Kenya, 2007. MMWR Morb Mortal Wkly Rep 56: 1109–1113.
Kenya National Bureau of Statistics (KNBS), ICF Macro, 2010. Kenya Demographic and Health Survey 2008–09. Calverton, MD: KNBS and ICF Macro.
Suchdev PS, Ruth L, Obure A, Were V, Ochieng C, Ogange L, Owuor M, Ngure F, Quick R, Juliao P, Jung C, Teates K, Cruz K, Jefferds ME, 2010. Monitoring the marketing, distribution, and use of Sprinkles micronutrient powders in rural western Kenya. Food Nutr Bull 31: S168–S178.
Rabie T, Curtis V, 2006. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health 11: 258–267.
UNICEF, 2011. Water, sanitation, and hygiene in schools. Available at: http://www.unicef.org/wash/index_schools.html. Accessed May 18, 2011.
The Global Public-Private Partnership for Handwashing with Soap, 2011. Available at: http://globalhandwashing.org/index.php. Accessed May 19, 2011.
Global Water Challenge, 2011. Available at: http://www.globalwaterchallenge.org/home/. Accessed May 19, 2011.
Freeman MC, Quick RE, Abbott DP, Ogutu P, Rheingans R, 2009. Increasing equity of access to point-of-use water treatment products through social marketing and entrepreneurship: a case study in western Kenya. J Water Health 7: 527–534.
Freeman MC, Clasen T, 2011. Assessing the impact of a school-based safe water intervention on household adoption of point-of-use water treatment practices in southern India. Am J Trop Med Hyg 84: 370–378.
Bowen A, Ma H, Ou J, Billhimer W, Long T, Mintz E, Hoekstra RM, Luby S, 2007. A cluster-randomized controlled trial evaluating the effect of a handwashing-promotion program in Chinese primary schools. Am J Trop Med Hyg 76: 1166–1173.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 3424 | 2735 | 93 |
Full Text Views | 3135 | 7 | 0 |
PDF Downloads | 326 | 7 | 0 |