Trial reportBMC medicine2021
Hand hygiene intervention to optimise soil-transmitted helminth infection control among primary school children: the Mikono Safi cluster randomised controlled trial in northwestern Tanzania.
Trial report in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.PloS one · 2024Pooled it
- Interventions to improve water, sanitation, and hygiene for preventing soil-transmitted helminth infection.The Cochrane database of systematic reviews · 2022Pooled it
- Methodology for measuring behavior change dictates the perceived effectiveness of school-based WASH interventions.Frontiers in public health · 2026Trial
- Prevalence and intensity of soil-transmitted helminths infections and associated factors among households in Gorgora, Ethiopia.Scientific reports · 2026Article
- Train-the-trainer model in public health practice: Feasibility of senior nursing students as catalysts for hand hygiene education in school-aged children.Journal of family medicine and primary care · 2026Article
- Soil-transmitted helminthiasis in the aftermath of conflict: assessing prevalence, intensity, and associated factors among school-age children in Tigray, Ethiopia, 2025.European journal of pediatrics · 2025Article
- WASH and learn: a scoping review of health, education and gender equity outcomes of school-based water, sanitation and hygiene in low-income and middle-income countries.BMJ global health · 2025Article
- Prevalence, Infection Intensity, and Risk Factors for Soil-transmitted Helminth Infections among School Children in Northwestern Tanzania.Pathogens (Basel, Switzerland) · 2024Article
- Determination of the Prevalence ofJournal of parasitology research · 2024Article
- Nongovernmental Organization Practitioners' Perspectives on the Challenges and Solutions to Changing Handwashing Behavior in Older Children: A Qualitative Study.Global health, science and practice · 2023Article
- Monks: A Population at Risk for Liver Fluke and Skin-Penetrating Helminths.Tropical medicine and infectious disease · 2023Article
- Does a school-based intervention to engage parents change opportunity for handwashing with soap at home? Practical experience from the Mikono Safi trial in Northwestern Tanzania.PLoS neglected tropical diseases · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundSoil-transmitted helminth (STH) infections are highly prevalent in resource-limited countries. We assessed the effect of a combination intervention aiming to enhance handwashing with soap on STH reinfection following mass drug administration among primary school children in Kagera region, Northwestern Tanzania.
methodsWe conducted a cluster randomised trial in sixteen primary schools with known high STH prevalence. Schools were randomly assigned in a 1:1 ratio to either receive the intervention or continue with routine health education. The intervention included teacher-led classroom teaching, parental engagement sessions, environmental modifications and improved handwashing stations. The evaluation involved two cross-sectional surveys in a representative sample of students, with the end-line survey conducted 12 months after the baseline survey. The primary outcome was the combined prevalence of Ascaris lumbricoides and Trichuris trichiura infections at the end-line survey. Secondary outcomes included reported handwashing behaviour, the prevalence and intensity of individual STHs, and hand contamination with STH ova and coliform bacteria. End-line STH prevalence and intensity were adjusted for baseline differences of potential confounders.
resultsAt the end-line survey, 3081 school children (1566 from intervention schools and 1515 from control schools) provided interview data and stool specimens. More school children in the intervention group reported the use of water and soap during handwashing compared to school children in the control group (58% vs. 35%; aOR=1.76, 95%CI 1.28-2.43, p=0.001). The combined prevalence of A. lumbricoides and T. trichiura infections was 39% in both trial arms (aOR = 1.19; 95%CI 0.74-1.91). The prevalence of A. lumbricoides was 15% in the intervention and 17% in the control arm (aOR =1.24, 95%CI 0.59-2.59) and that of T. trichiura was 31% in both arms (aOR=1.17, 95%CI 0.73-1.88). No significant differences were found for STH infection intensity in both the main study and the hand contamination sub-study.
conclusionsThe intervention was effective in increasing reported handwashing behaviour at school, but failed to show a similar effect in the home. The intervention had no effect on STH infection, possibly due to infection in the home environment, other transmission routes such as contaminated water or food or limited changes in school children's handwashing behaviour.
trial registrationThe trial was registered on June 21, 2017, by the International Standard Randomised Controlled Trial Number ( ISRCTN45013173) .
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.