Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, Maryland, United States of America.
Kongwa Trachoma Project, Kongwa, Tanzania.
PLoS Negl Trop Dis. 2021 Feb 1;15(2):e0009119. doi: 10.1371/journal.pntd.0009119. eCollection 2021 Feb.
Health promotion is essential to the SAFE strategy for trachoma elimination. Schools are a valuable venue for health promotion. However, there is little literature about the impact of health education and water infrastructure in schools on facial cleanliness and trachoma in the community. Our study aimed to describe the current state of school health promotion in Kongwa, Tanzania, and to examine the transferability of health messages from schools to the community at large.
METHODOLOGY/FINDINGS: A cross-sectional survey was carried out in all 92 villages in Kongwa district, which included 85 primary schools. Data were collected on health messages and water infrastructure in the schools. A random sample of 3084 children aged 0-5 were examined for facial cleanliness in all villages. In 50 villages, a random sample of 50 children aged 1-9 per village were examined for follicular trachoma (TF). Thirty-seven (44.6%) schools had educational materials on face-washing. Fifty (60.2%) schools had a washing station. The presence of a health teacher was correlated with having posters on face washing in classrooms. The presence of face-washing materials was correlated with the availability of washing stations. Neither teachers mentioning face-washing in health curricula nor educational materials in classrooms were associated with clean faces or trachoma in the community. Having a washing station in the school was associated with lower community rates of trachoma.
Primary school health messages and materials on trachoma were not associated with clean faces or lower rates of trachoma in the community. The target audience for primary school health promotion is likely the students themselves, without immediate rippling effects in the community. A long-term perspective should be considered during the implementation of health promotion in schools. The goal of school health promotion should be training the next generation of parents and community health leaders in combatting trachoma.
健康促进对于沙眼消除的 SAFE 策略至关重要。学校是健康促进的一个有价值的场所。然而，关于学校健康教育和水基础设施对社区面部清洁和沙眼的影响，文献很少。我们的研究旨在描述坦桑尼亚 Kongwa 地区学校健康促进的现状，并研究从学校向整个社区传递健康信息的可转移性。
方法/发现：在 Kongwa 区的 92 个村庄进行了一项横断面调查，其中包括 85 所小学。在学校收集了健康信息和水基础设施的数据。在所有村庄，对 0-5 岁的 3084 名儿童进行了面部清洁随机抽样检查。在 50 个村庄中，对每个村庄随机抽取 50 名 1-9 岁的儿童进行滤泡性沙眼（TF）检查。37 所（44.6%）学校有关于洗脸的教育材料。50 所（60.2%）学校有一个洗漱站。有卫生教师的学校更有可能在教室贴有关于洗脸的海报。有洗脸材料的学校更有可能有洗漱站。在健康课程中提到洗脸的教师人数以及教室中的教育材料数量均与社区的面部清洁或沙眼发病率无关。学校有洗漱站与社区沙眼发病率较低有关。
小学关于沙眼的健康信息和材料与社区的面部清洁或沙眼发病率较低无关。小学健康促进的目标人群可能是学生本身，而不会对社区产生即时的连锁反应。在实施学校健康促进时，应考虑长期视角。学校健康促进的目标应该是培训下一代父母和社区沙眼防治的卫生领袖。
