Evaluation of the intervention effect of comprehensive prevention and control measures on enterobiasis among children in Nanjing City

doi:10.12140/j.issn.1000-7423.2024.04.010

Abstract

Abstract:

Objective To evaluate the intervention effect of comprehensive prevention and control measures on enterobiasis among children so as to provide a informative basis for formulating and adjusting the prevention and control strategies. Methods Using random cluster sampling method, one kindergarten was selected from each of the 12 districts in Nanjing to conduct a survey on the infection of Enterobius vermicularis among all children in September to October 2022. Based on the survey results, four kindergartens with higher infection rates and similar environment and scale were selected from both urban and suburban areas, respectively. All children from 8 kindergartens, one guardian living with each child and the class teacher of each class were enrolled in the survey. Among them, two kindergartens in the urban area and two in the suburbs were assigned as the experimental group implemnting comprehensive control measures, while the remaining four kindergartens as the control group carring out traditional control measures; both groups conducted one-year intervention from November 2022 to November 2023. For the experimental group, the intervention measres comprised of symptom surveillance (on children’s suspected symptoms of Enterbobius infection), companion surveillance (sampling test for positive children’s family members living together with, classmates and playmates), and environmental surveillance (using transparent adhesive tape pasting method to collect environmental samples from positive children’s families and classes), as well as health education with three-dimension of “knowledge, attitude, and practice” as entering point to perform educational intervention jointly with multiple sectors including families, schools, and communities. The intervention measures for the control group were deworming for positive children only and health education delivered to the children and their family members. The After completion of the intervention study, anal swab method with transparent adhesive tape was used to examine the E. vermicularis infection rate in the children of two groups, respectively. Before and after the inervention, questionnaire survey on E. vermicularis control related knowledge was delivered to one class teacher of each class and one guardian living with each child, respectively. Results Before the intervention, the E. vermicularis infection rates in the experimental group and the control group were 1.5% (13/885) and 1.4% (12/886), respectively, showing no significant difference between the two groups (χ² = 0.042, P > 0.05). A total of 234 children with suspected symptoms were found during symptom monitoring in the experimental group, among them, anal itching proportion was found the highes (34.62%, 81/234), followed by sleeping teeth grinding symptom (20.5%, 48/234). A total of 8 positive cases were detected, of which symptoms of anal itching accounted for the highest (5/8), followed by symptoms of sleeping teeth grinding (2/8). In companion surveillance, four positives were detected from positive children’s family members and two positives from their classmates, repectively. In environmental surveillance, four positives were found from plush toys samples, and two positive samples of blankets, sheets, and sofas were detected in the positive children’s family environment, respectively, and one positive sample was found from the desk and chair of their classroom, respectively. After one-year intervention, the infection rate in the experimental group decreased from 1.5% (13/885) before intervention to 0.1% (1/885) (χ² = 10.368, P < 0.05), which was significantly lower than that in the control group after intervention (0.9%，8/886) (χ² = 4.014, P < 0.05). The questionnaire showed that prior to the intervention, there was no significant difference in positive response rate towards children’s hygiene behaviour habits, and parents’ and teachers’ awareness points regarding to enterobiasis “knowledge, attitude, and practice” between the two the groups (all P > 0.05). The correct response rates to the questions “whether washing hands before and after meals, habits of trimming nails, biting fingers and biting toys”(89.9%, 796/885; 88.9%, 787/885; 85.8%, 759/885; 86.8%, 768/885) and correct hygiene habits rates of “whether have a separate towel, frequency of weekly showers, and frequency of monthly bedding drying” (89.2%, 789/885; 85.7%, 758/885; 78.9%, 698/885) in the experimental group were significantly higher than those in the control group (61.7%, 547/886; 71.2%, 631/886; 56.2%, 498/886; 59.8%, 530/886; 78.8%, 698/886; 78.8%, 698/886; 68.6%, 608/886) after intervention (χ² = 192.194, 86.989, 187.741, 164.402, 35.371, 14.285, 24.010; all P < 0.05). After intervention, the positive response rates to all questions towards enterobiasis “knowledge, attitude, and practice” the experimental group were significantly higher those in the control group (all P < 0.05). In post-intervention, the positive response to all questions towards awareness of enteroviasis in teachers were all significantly higher than those in the control group (all P < 0.05). Conclusion Implementation of comprehensive prevention and control measures effectively reduced E. vermicularis infection rate in children, achieved timely interruption and precise control, meanwhile, raised parents’ and teachers’ health awareness and cognitive level on enterobiasis, and promoted changes of their attitudes and behaviours, driving children to develop good hygiene habits, and leading to effectively prevent and interrupt the transmission and spread of enterobiasis.

Key words: Enterobius vermicularis, Comprehensive prevention and control measures, Children, Intervene, Health education

CLC Number:

R532.13

HE Yisha, YANG Peicai, YIN Weigang, XIE Chaoyong. Evaluation of the intervention effect of comprehensive prevention and control measures on enterobiasis among children in Nanjing City[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2024, 42(4): 487-495.

Figures/Tables 4

Table 1

Table 2

Survey of hygiene behaviour habits of children before and after the intervention of comprehensive prevention and control intervention measures for childhood enterobiasis (experimental group) and traditional enterobiasis prevention and control measures (control group) in Nanjing City

儿童卫生行为习惯 Children’s hygienic behavior	干预前 Pre-intervention		χ²值 χ² value	P值 P value	干预后 Post-intervention		χ²值 χ² value	P值 P value
儿童卫生行为习惯 Children’s hygienic behavior	实验组人数（占比/%）No. experimental group (Proportion/%)	对照组人数（占比/%）No. control group (Proportion/%)	χ²值 χ² value	P值 P value	实验组人数（占比/%）No. experimental group (Proportion/%)	对照组人数（占比/%）No. control group (Proportion/%)	χ²值 χ² value	P值 P value
饭前便后是否洗手 Whether wash handsbefore meals and after using toilet
是 Yes	505（57.1）	512（57.8）	0.095	> 0.05	796（89.9）	547（61.7）	192.194	< 0.05
否 No	380（42.9）	374（42.2）			89 （10.1）	339（38.3）
是否勤剪指甲 Whether keep fingernails short
是 Yes	596（67.3）	599（67.6）	0.014	> 0.05	787（88.9）	631（71.2）	86.989	< 0.05
否 No	289（32.7）	287（32.4）			98（11.1）	255（28.8）
是否有咬手指习惯 Whether suck fingers
是 Yes	405（45.8）	413（46.6）	0.129	> 0.05	126（14.2）	388（43.8）	187.741	< 0.05
否 No	480（54.2）	473（53.4）			759（85.8）	498（56.2）
是否有咬玩具等习惯 Whether suck toys
是 Yes	398（45.0）	385（43.5）	0.414	> 0.05	117（13.2）	356（40.2）	164.402	< 0.05
否 No	487（55.0）	501（56.5）			768（86.8）	530（59.8）
有无喝生水习惯 Whether drink unboiled water
有 Yes	12（1.4）	13（1.5）	0.039	> 0.05	8（0.9）	11（1.2）	0.475	> 0.05
无 No	873（98.6）	873（98.5）			877（99.1）	875（98.8）
有无单独毛巾 Whether have a separate towel
有 Yes	689（77.9）	695（78.4）	0.090	> 0.05	789（89.2）	698（78.8）	35.371	< 0.05
无 No	196（22.1）	191（21.6）			96（10.8）	188（21.2）
每周洗澡频率 Frequency of weekly shower
2次及以上 Two or more times	683（77.2）	692（78.1）	0.220	> 0.05	758（85.7）	698（78.8）	14.285	< 0.05
≤ 1次 Less than or equal to one time	202（22.8）	194（21.9）			127（14.3）	188（21.2）
每月被褥晾晒频率 Frequency of monthly sunshining beddings
2次及以上 Two or more times	591（66.8)	599（67.6)	0.138	> 0.05	698（78.9）	608（68.6）	24.010	< 0.05
≤ 1次 Less than or equal to one time	294（33.2)	287（32.4)			187（21.1）	278（31.4）

Table 2

Table 3

“Knowledge, attitude and practice” on enterobiasis among parents before and after the intervention of comprehensive prevention and control intervention measures for childhood enterobiasis (experimental group) and traditional enterobiasis prevention and control measures (control group) in Nanjing City

家长蛲虫病知信行情况 Parents’ knowledge, attitude and practice of enterobiasis	干预前 Pre-intervention		χ²值 χ² value	P值 P value	干预后 Post-intervention		χ²值 χ² value	P值 P value
	实验组人数（占比/%）No. experimental group (Proportion/%)	对照组人数（占比/%）No. control group (Proportion/%)	χ²值 χ² value	P值 P value	实验组人数（占比/%）No. experimental group (Proportion/%)	对照组人数（占比/%）No. control group (Proportion/%)	χ²值 χ² value	P值 P value
是否知道蛲虫病 Whether know enterobiasis
是 Yes	402（45.4）	405（45.7）	0.015	> 0.05	695（78.5）	360（40.6）	264.050	< 0.05
否 No	483（54.6）	481（54.3）			190（21.5）	526（59.4）
是否知道它会传染 Whether know enterobiasis is contagious
是 Yes	329（37.2）	322（36.3）	0.132	> 0.05	680（76.8）	334（37.7）	277.123	< 0.05
否 No	556（62.8）	564（63.7）			205（23.2）	552（62.3）
是否知道它的感染途径 Whether know its route of infection
是 Yes	223（25.2）	231（26.1）	0.178	> 0.05	665（75.1）	298（33.6）	307.467	< 0.05
否 No	662（74.8）	655（73.9）			220（24.9）	588（66.4）
是否知道它的主要症状 Whether know its main symptoms
是 Yes	205（23.2）	210（23.7）	0.071	> 0.05	656（74.1）	251（28.3）	371.625	< 0.05
否 No	680（76.8）	676（76.3）			229（25.9）	635（71.7）
是否知道它的易感人群 Whether know its susceptible population
是 Yes	401（45.3）	403（45.5）	0.005	> 0.05	690（78.0）	465（52.5）	126.746	< 0.05
否 No	484（54.7）	483（54.5）			195（22.0）	421（47.5）
是否知道如何预防蛲虫病 Whether know its prevention methods
是 Yes	398（45.0）	392（44.2）	0.095	> 0.05	693（78.3）	460（51.9）	135.686	< 0.05
否 No	487（55.0）	494（55.8）			192（21.7）	426（48.1）
饭前便后是否洗手 Whether wash hands before meals and after usingtoilet
是 Yes	692（78.2）	698（78.8）	0.091	> 0.05	820（92.7）	701（79.1）	66.910	< 0.05
否 No	193（21.8）	188（21.2）			65（7.3）	185（20.9）
家里打扫卫生频率 Cleaning frequency
2次及以上 Two or more times	389（44.0）	385（43.5）	0.045	> 0.05	478（54.0）	390（44.0）	17.693	< 0.05
≤ 1次 Less than or equal to one time	496（56.0）	501（56.5）			407（46.0）	496（56.0）
儿童与成人衣服是否分开洗 Children and adults wash clothes separately
是 Yes	501（56.6）	515（58.1）	0.416	> 0.05	762（86.1）	501（56.5）	189.061	< 0.05
否 No	384（43.4）	371（41.9）			123（13.9）	385（43.5）
是否愿意吃药治疗蛲虫病 Whether willing to take medicine for enterobiasis
是 Yes	658（74.4）	662（74.7）	0.032	> 0.05	780（88.1）	665（75.1）	50.428	< 0.05
否 No	227（25.6）	224（25.3）			105（11.9）	221（24.9）
是否愿意改变不良习惯预防蛲虫病 Whether willing to change bad habits to prevent enterobiasis
是 Yes	780（88.1）	787（88.8）	0.207	> 0.05	820（92.7）	783（88.4）	9.449	< 0.05
否 No	105（11.9）	99（11.2）			65（7.3）	103（11.6）

Table 3

Table 4

“Knowledge, attitude and practice” on enterobiasis among teachers before and after the intervention of comprehensive prevention and control intervention measures for childhood enterobiasis (experimental group) and traditional enterobiasis prevention and control measures (control group) in Nanjing City

教师蛲虫病知信行情况 Teachers’ knowledge, attitude and practice of enterobiasis	干预前						χ²值 χ² value			P值 P value			干预后								χ²值 χ² value		P值 P value
	实验组人数（占比/%）No. experimental group (Proportion/%)			对照组人数（占比/%）No. control group (Proportion/%)			χ²值 χ² value			P值 P value			实验组人数（占比/%）No. experimental group (Proportion/%)			对照组人数（占比/%）No. control group (Proportion/%)					χ²值 χ² value		P值 P value
是否知道蛲虫病 Whether know enterobiasis
是 Yes	48（64.0）			50 (64.9)			0.015			> 0.05			70 (93.3)			56 (72.7)					11.377		< 0.05
否 No	27 (36.0)			27 (35.1)									5 (6.7)			21 (27.3)
是否知道它会传染 Whether know enterobiasis is contagious
是 Yes	45 (60.0)			48 (62.3)			0.087			> 0.05			69 (92.0)			55 (71.4)					10.699		< 0.05
否 No	30 (40.0)			29 (37.7)									6 (8.0)			22 (28.6)
是否知道它的感染途 Whether know its route of infection
是 Yes	40 (53.3)			44 (57.1)			0.223			> 0.05			67 (89.3)			53 (68.8)					9.609		< 0.05
否 No		35 (46.7)			33 (42.9)									8 (10.7)			24 (31.2)
是否知道它的主要症状 Whether know its main symptoms
是 Yes		38 (50.7)			40 (51.9)			0.025			> 0.05			68 (90.7)			54 (70.1)		10.115			< 0.05
否 No		37 (49.3)			37 (48.1)									7 (9.3)			23 (29.9)
是否知道它的易感人群 Whether know its susceptible population
是 Yes		48 (64.0)			46 (59.7)			0.292			> 0.05			69 (92.0)			56 (72.7)		9.661			< 0.05
否 No		27 (36.0)			31 (40.3)									6 (8.0)			21 (27.3)
是否知道如何预防蛲虫病 Whether know its prevention methods
是 Yes		47 (62.7)			43 (55.8)			0.732			> 0.05			67 (89.3)			54 (70.1)		8.630			< 0.05
否 No		28 (37.3)			34 (44.2)									8 (10.7)			23 (29.9)
饭前便后是否洗手 Whether wash hands before mealsand after using toilet
是 Yes		70 (93.3)			68 (88.3)			1.146			> 0.05			74 (98.7)			70 (90.9)		3.162			> 0.05
否 No		5 (6.7)			9 (11.7)									1 (1.3)			7 (9.1)
是否愿意吃药治疗蛲虫病 Whether willing to take medicine for enterobiasis
是 Yes		68 (90.7)			71 (92.2)			0.115			> 0.05			74 (98.7)			71 (92.2)		2.287			> 0.05
否 No		7 (9.3)			6 (7.8)									1 (1.3)			6 (7.8)
是否愿意改变不良习惯预防蛲虫病 Whether willing to change bad habits to prevent enterobiasis
是 Yes			70 (93.3)			69 (89.6)			0.673			> 0.05			74 (98.7)			72 (93.5)		1.481		> 0.05
否 No			5 (6.7)			8 (10.4)									1 (1.3)			5 (6.5)

Table 4

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特征 Characteristics	实验组人数（占比/%） No. experimental group (Proportion/%)	对照组人数（占比/%） No. control group (Proportion/%)	χ²值 χ² value	P值 P value
性别 Gender
男 Male	473（53.5）	469（52.9）	0.047	> 0.05
女 Female	412（46.5）	417（47.1）
年龄/岁 Age/Year
3	122（13.8）	102（11.5）	3.580	> 0.05
4	269（30.4）	257（29.0）
5	285（32.2）	293（33.1）
6	209（23.6）	234（26.4）
年级 Grade
小班 Junior	180（20.3）	153（17.3）	2.801	> 0.05
中班 Middle	327（37.0）	335（37.8）
大班 Senior	378（42.7）	398（44.9）
幼儿园性质 Nature of kindergarten
公办 Public	514（58.1）	531（59.9）	0.629	> 0.05
民办 Private	371（41.9）	355（40.1）
居住地 Place of residence
城镇 Urban	483（54.6）	478（54.0）	0.070	> 0.05
农村 Rural	402（45.4）	408（46.0）
父母文化程度 Educational level of parents
小学及以下 Primary school and below	231（26.1）	237（26.7）	2.764	> 0.05
初、高中/中专 High school	260（29.4）	287（32.4）
大专及以上 College and above	394（44.5）	362（40.9）
父母职业类型 Occupation type of parents
农民 Farmer	20（2.3）	30（3.4）	5.696	> 0.05
工人 Worker	320（36.2）	290（32.7）
自营工商业者 Businessman	319（36.0）	325（36.7）
国家工作人员 State staff	150（16.9）	146（16.5）
其它 Others	76（8.6）	95（10.7）