Okabayashi Hironori, Thongthien Pimpimon, Singhasvanon Pratap, Waikagul Jitra, Looareesuwan Sornchai, Jimba Masamine, Kano Shigeyuki, Kojima Somei, Takeuchi Tsutomu, Kobayashi Jun, Tateno Seiki
The Asian Centre of International Parasite Control, Faculty of Tropical Medicine, Mahidol University, Thailand.
Parasitol Int. 2006 Jun;55(2):121-6. doi: 10.1016/j.parint.2005.11.056. Epub 2006 Jan 6.
School-based malaria control has been recognized as a new approach for the control of this disease in the Greater Mekong Subregion since 2000. We evaluated a school-based malaria control program near the western border of Thailand using a before-after intervention study. The major intervention activities included teacher training with specialized malaria teaching materials and participatory learning methods. The target population was 17 school principals, 111 teachers and 852 schoolchildren of grade 3, 4, and 5 in 17 schools. After the intervention, the teachers taught about malaria more actively than before. The teachers who could design a lesson plan on malaria increased from 30.7% to 47.7% (p=0.015) and the teachers who had taught about malaria increased from 71.9% to 84.3% (p=0.035). As a result of the program, the schoolchildren changed their behavior positively towards malaria prevention with significant difference in 6 of 7 questions. For example, the schoolchildren 'who always took care of mosquito bites' increased from 42.7% to 62.1% (p<0.001) and the schoolchildren 'who always reported their parents or teachers when they had fever' increased from 36.0% to 56.0% (p<0.001). In conclusion, the keys to a successful intervention lie in good teaching materials and a participatory approach utilizing the well-established Thailand's school health system. Beyond Thailand, school-based malaria control could be applied to other Greater Mekong Subregion countries with careful analysis of school health context in each country.
自2000年以来，以学校为基础的疟疾防控已被视为大湄公河次区域控制该疾病的一种新方法。我们采用干预前后研究，对泰国西部边境附近的一个以学校为基础的疟疾防控项目进行了评估。主要干预活动包括使用专门的疟疾教材和参与式学习方法对教师进行培训。目标人群是17所学校的17名校长、111名教师以及三、四、五年级的852名学童。干预后，教师们比以前更积极地讲授疟疾知识。能够设计疟疾课程计划的教师比例从30.7%增至47.7%（p = 0.015），讲授过疟疾知识的教师比例从71.9%增至84.3%（p = 0.035）。由于该项目，学童在预防疟疾方面的行为发生了积极变化，在7个问题中有6个存在显著差异。例如，“总是注意防蚊叮咬”的学童比例从42.7%增至62.1%（p<0.001），“发烧时总是告知父母或老师”的学童比例从36.0%增至56.0%（p<0.001）。总之，成功干预的关键在于优质教材以及利用泰国完善的学校卫生系统的参与式方法。在泰国以外，经过对每个国家学校卫生情况的仔细分析，以学校为基础的疟疾防控可应用于大湄公河次区域的其他国家。
