School-based intervention: evaluating the role of water, latrines and hygiene education on trachoma and intestinal parasitic infections in Ethiopia

We sought to evaluate the impact of a hygiene and sanitation intervention program among school-children to control active trachoma and intestinal parasitic infections. This longitudinal epidemiologic study was conducted among 630 students in rural Ethiopia. Baseline and follow-up surveys were conducted to evaluate the impact of a three-pronged intervention program: (i) construction of ventilated improved pit latrines; (ii) provision of clean drinking water; and (iii) hygiene education. Socio-demographic information was collected using a structured questionnaire. Presence of trachoma and intestinal parasitic infections were evaluated using standard procedures. At baseline, 15% of students had active trachoma, while 6.7% of them were found to have active trachoma post-intervention (p < 0.001). Similar improvements were noted for parasitic infections. At baseline, 7% of students were reported to have helminthic infections and 30.2% protozoa infections. However, only 4% of students had any helminthic infection and 13.4% (p < 0.001) of them were found to have any protozoa infection during follow-up surveys. Improvements were also noted in students' knowledge and attitudes towards hygiene and sanitation. In summary, the results of our study demonstrated that provision of a comprehensive and targeted sanitation intervention program was successful in reducing the burden of trachoma and intestinal parasitic infection among schoolchildren.