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School Children’s Intestinal Parasite and Nutritional Status One Year after Complementary School Garden, Nutrition, Water, Sanitation, and Hygiene Interventions in Burkina Faso
Séverine Erismann
Séverine Erismann
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
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University of Basel, Basel, Switzerland;
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Serge Diagbouga
Serge Diagbouga
Institut de Recherches en Sciences de la Santé, Ouagadougou, Burkina Faso;
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Christian Schindler
Christian Schindler
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
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University of Basel, Basel, Switzerland;
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Peter Odermatt
Peter Odermatt
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
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Astrid M. Knoblauch
Astrid M. Knoblauch
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
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University of Basel, Basel, Switzerland;
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Jana Gerold
Jana Gerold
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
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University of Basel, Basel, Switzerland;
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Andrea Leuenberger
Andrea Leuenberger
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
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Akina Shrestha
Akina Shrestha
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
Kathmandu University, Dhulikhel, Nepal
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Kathmandu University, Dhulikhel, Nepal
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Grissoum Tarnagda
Grissoum Tarnagda
Institut de Recherches en Sciences de la Santé, Ouagadougou, Burkina Faso;
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Jürg Utzinger
Jürg Utzinger
Swiss Tropical and Public Health Institute, Basel, Switzerland;
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Guéladio Cissé
Guéladio Cissé
Swiss Tropical and Public Health Institute, Basel, Switzerland;
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The potential health benefits of combined agricultural, nutrition, water, sanitation, and hygiene (WASH) interventions are poorly understood. We aimed to determine whether complementary school garden, nutrition, and WASH interventions reduce intestinal parasites and improve school children’s nutritional status in two regions of Burkina Faso. A cluster-randomized controlled trial was conducted in the Plateau Central and Center-Ouest regions of Burkina Faso. A total of 360 randomly selected children, aged 8–15 years, had complete baseline and end-line survey data. Mixed regression models were used to assess the impact of the interventions, controlling for baseline characteristics. The prevalence of intestinal parasitic infections decreased both in intervention and control schools, but the decrease was significantly higher in the intervention schools related to the control schools (odds ratio [OR] of the intervention effect = 0.2, 95% confidence interval [CI] = 0.1–0.5). Indices of undernutrition did not decrease at end-line in intervention schools. Safe handwashing practices before eating and the use of latrines at schools were significantly higher in the intervention schools than in the control schools at end-line (OR = 6.9, 95% CI = 1.4–34.4, and OR = 14.9, 95% CI = 1.4–153.9, respectively). Parameters of water quality remained unchanged. A combination of agricultural, nutritional, and WASH-related interventions embedded in the social–ecological systems and delivered through the school platform improved several child health outcomes, including intestinal parasitic infections and some WASH-related behaviors. Sustained interventions with stronger household and community-based components are, however, needed to improve school children’s health in the long-term.
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Author Notes
Financial support: This work is part of the “Vegetables go to School” research project (Collaborative Project); supported by the Swiss Agency for Development and Cooperation under grant agreement contract number 81024052 (project 7F-08511.01). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Authors’ addresses: Séverine Erismann, Christian Schindler, Peter Odermatt, Astrid M. Knoblauch, Jana Gerold, Andrea Leuenberger, Jürg Utzinger, and Guéladio Cissé, Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Basel, Switzerland, E-mails: severine.erismann@swisstph.ch, christian.schindler@swisstph.ch, peter.odermatt@swisstph.ch, astrid.knoblauch@swisstph.ch, jana.gerold@swisstph.ch, leuenberger.andrea@gmail.com, juerg.utzinger@swisstph.ch, and gueladio.cisse@swisstph.ch. Serge Diagbouga and Grissoum Tarnagda, Institut de Recherches en Sciences de la Santé, Ouagadougou, Burkina Faso, E-mails: diagbouga_serge@hotmail.com and gtarnagda@gmail.com. Akina Shrestha, Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland, and Kathmandu University, Dhulikhel, Nepal, E-mail: akina.shrestha@swisstph.ch.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Daboné C, Delisle HF, Receveur O, 2011. Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou (Burkina Faso). Nutr J 10: 34.
-
2.
INSD and ICF International, 2012. Enquête Démographique et de Santé et à Indicateurs Multiples du Burkina Faso 2010. Calverton, MD: Institut National de la Statistique et de la Démographie and ICF International.
-
3.
Erismann S et al.., 2016. Prevalence of intestinal parasitic infections and associated risk factors among schoolchildren in the Plateau Central and Centre-Ouest regions of Burkina Faso. Parasit Vectors 9: 554.
-
4.
Erismann S et al.., 2017. Prevalence and risk factors of undernutrition among schoolchildren in the Plateau Central and Centre-Ouest regions of Burkina Faso. Infect Dis Poverty 6: 17.
-
5.
Ameratunga S, Denny S, 2016. GBD 2013: a window into the world of young people. Lancet 387: 2353–2354.
-
6.
Utzinger J, N’Goran EK, Caffrey CR, Keiser J, 2011. From innovation to application: social-ecological context, diagnostics, drugs and integrated control of schistosomiasis. Acta Trop 120 (Suppl 1) :S121–S137.
-
7.
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-
8.
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-
9.
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-
10.
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-
11.
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-
12.
Katona P, Katona-Apte J, 2008. The interaction between nutrition and infection. Clin Infect Dis 46: 1582–1588.
-
13.
Ziegelbauer K, Speich B, Mäusezahl D, Bos R, Keiser J, Utzinger J, 2012. Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS Med 9: e1001162.
-
14.
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-
15.
Nakagawa J et al.., 2015. Towards effective prevention and control of helminth neglected tropical diseases in the Western Pacific Region through multi-disease and multi-sectoral interventions. Acta Trop 141: 407–418.
-
16.
Bundy DAP et al.., 2006. School-based health and nutrition programs. Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P, eds. Disease Control Priorities in Developing Countries. Washington, DC: World Bank.
-
17.
Food and Agriculture Organization, 2010. A new deal for school gardens. Rome, Italy: Food and Agriculture Organization.
-
18.
Bundy DAP, 2009. Rethinking School Feeding: Social Safety Nets, Child Development, and the Education Sector. Washington, DC: The International Bank for Reconstruction and Development/World Bank.
-
19.
Park S, Lee EY, Gittelsohn J, Nkala D, Choi BY, 2015. Understanding school health environment through interviews with key stakeholders in Lao PDR, Mongolia, Nepal and Sri Lanka. Health Educ Res 30: 285–297.
-
20.
Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, Webb P, Lartey A, Black RE, 2013. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 382: 452–477.
-
21.
Monse B, Benzian H, Naliponguit E, Belizario V, Schratz A, van Palenstein Helderman W, 2013. The fit for school health outcome study-a longitudinal survey to assess health impacts of an integrated school health programme in the Philippines. BMC Public Health 13: 256.
-
22.
Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, Haider BA, Kirkwood B, Morris SS, Sachdev HP, Shekar M, 2008. What works? Interventions for maternal and child undernutrition and survival. Lancet 371: 417–440.
-
23.
Ruel MT, Alderman H, 2013. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 382: 536–551.
-
24.
Waage J, Hawkes C, Turner R, Ferguson E, Johnston D, Shankar B, McNeill G, Hussein J, Homans H, Marais D, 2013. Current and planned research on agriculture for improved nutrition: a mapping and a gap analysis. Proc Nutr Soc 72: E316.
-
25.
Christian MS, Evans CE, Nykjaer C, Hancock N, Cade JE, 2014. Evaluation of the impact of a school gardening intervention on children’s fruit and vegetable intake: a randomised controlled trial. Int J Behav Nutr Phys Act 11: 99.
-
26.
Olney DK, Bliznashka L, Pedehombga A, Dillon A, Ruel MT, Heckert J, 2016. A 2-year integrated agriculture and nutrition program targeted to mothers of young children in Burkina Faso reduces underweight among mothers and increases their empowerment: a cluster-randomized controlled trial. J Nutr 146: 1109–1117.
-
27.
Erismann S et al.., 2016. Complementary school garden, nutrition, water, sanitation and hygiene interventions to improve children’s nutrition and health status in Burkina Faso and Nepal: a study protocol. BMC Public Health 16: 244.
-
28.
Ministère de la Santé (Burkina Faso), 2010. Plan Strategique Nutrition 2010–2015. Ouagadougou, Burkina Faso: Ministère de la Santé.
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29.
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-
30.
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-
31.
Schulz KF, Altman DG, Moher D, 2010. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Med 8: 18.
-
32.
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-
33.
World Health Organization, 2011. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Geneva, Switzerland: World Health Organization.
-
34.
Katz N, Chaves A, Pellegrino J, 1972. A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo 14: 397–400.
-
35.
Utzinger J et al.., 2010. Microscopic diagnosis of sodium acetate-acetic acid-formalin-fixed stool samples for helminths and intestinal protozoa: a comparison among European reference laboratories. Clin Microbiol Infect 16: 267–273.
-
36.
World Health Organization, 1994. Bench Aids for the Diagnosis of Intestinal Parasites. Geneva, Switzerland: World Health Organization, 1–20.
-
37.
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