Estimation of the cost of large-scale school deworming programmes with benzimidazoles

This study estimates the cost of distributing benzimidazole tablets in the context of school deworming programmes: we analysed studies reporting the cost of school deworming from seven countries in four WHO regions.The estimated cost for drug procurement to cover one million children (including customs clearance and international transport) is approximately US$20 000.The estimated financial costs (including the cost of training of personnel, drug transport, social mobilization and monitoring) is, on average, equivalent to US$33 000 per million school-age children with minimal variation in different countries and continents.The estimated economic costs of distribution (including the time spent by teachers, and health personnel at central, provincial and district level) to cover one million children approximately corresponds to US$19 000. This study shows the minimal cost of school deworming activities, but also shows the significant contribution (corresponding to a quarter of the entire cost of the programme) provided by health and education systems in endemic countries even in the case of drug donations and donor support of distribution costs.     

Financial costs of deworming children in all primary schools in Cambodia

In 2002, Cambodia's Ministry of Health launched a deworming programme to deliver an anthelmintic drug (mebendazole 500 mg) and health education to 75% of its school children twice a year. Cambodia's school population is approximately 2.8 million. The deworming programme was organized into two phases: the first phase (December 2002-March 2003) targeted more than one million school children from 11 provinces; and the second phase (July 2003-January 2004) targeted the entire school population. The cost to treat each child was 12 cents (0.11 USD) during the first phase, 6 cents during the second phase, and 3 cents for re-treatment in areas where the campaign was conducted for the second time. The Cambodian experience demonstrates that, with political commitment, high coverage for deworming is achievable even in a country with minimal resources. Cambodia's deworming programme represents a successful model for other developing countries.     

Coverage and costs of a school deworming programme in 2007 targeting all primary schools in Lao PDR

Infections with soil-transmitted helminths (STHs) are among the commonest infections in Lao PDR. Recent investigation in this country showed that intestinal helminths currently infect the majority of school-aged children. The Lao Government has addressed the problem by organizing regular anthelminthic chemotherapy with mebendazole 500mg for school and pre-school children in conjunction with health education activities incorporated into the national school curriculum. The school deworming campaign in Lao PDR reached a national coverage rate of 95% at a cost of US$0.124/head for two rounds of deworming per year. The programme operates under the umbrella of the national school health programme. After 1 year (two rounds of deworming) the intervention reduced the prevalence of Ascaris lumbricoides from 60% to 20% and of Trichuris trichiura from 42% to 31%. Although infection was not eliminated by the deworming interventions, over 90% of those children who remain infected had a 'light' infection. The virtual absence of high and moderate intensity infection demonstrates the effectiveness of periodical deworming in reducing morbidity due to STHs. We expect that additional rounds of deworming will further reduce the STH prevalence in Lao PDR.     

上海市徐汇区小学生控烟干预研究

目的探索小学生学校控烟于预的模式并予以评价。方法采用两阶段整群抽样的方法，选取两所小学的所有四、五年级学生566人为研究对象。对干预组进行为期一年的综合控烟干预。评价采用自填调查问卷的方法，在干预前、干预后、干预后半年分别进行调查。结果干预后干预组一年内的尝试吸烟率由7．8％下降到2．6％，被动吸烟率由53．6％下降到41．8％，有关烟草预防的认知、态度、技能也有所提高。但干预后半年干预组个别指标有所回落。结论学校综合性控烟干预是可行、有效的，但干预效果还需加以巩固。     

Cost effectiveness of recruitment methods in an obesity prevention trial for young children

BACKGROUND: Recruitment of participants for clinical trials requires considerable effort and cost. There is no research on the cost effectiveness of recruitment methods for an obesity prevention trial of young children. METHODS: This study determined the cost effectiveness of recruiting 70 families with a child aged 4 to 7 (5.9+/-1.3) years in Western New York from February 2003 to November 2004, for a 2-year randomized obesity prevention trial to reduce television watching in the home. RESULTS: Of the 70 randomized families, 65.7% (n=46) were obtained through direct mailings, 24.3% (n=17) were acquired through newspaper advertisements, 7.1% (n=5) from other sources (e.g., word of mouth), and 2.9% (n=2) through posters and brochures. Costs of each recruitment method were computed by adding the cost of materials, staff time, and media expenses. Cost effectiveness (money spent per randomized participant) was US $0 for other sources, US $227.76 for direct mailing, US $546.95 for newspaper ads, and US $3,020.84 for posters and brochures. CONCLUSION: Of the methods with associated costs, direct mailing was the most cost effective in recruiting families with young children, which supports the growing literature of the effectiveness of direct mailing.     

高水平公共卫生学院建设在疾病预防控制中心发展中的作用

教育部等四部门联合发布《关于开展高水平公共卫生学院建设的通知》, 提出要用十年时间建设一批高水平公共卫生学院, 形成适应现代化公共卫生体系建设的高质量教育发展体系。目前国内各高校高水平公共卫生学院的建设发展迅速。高水平公共卫生学院和疾病预防控制中心(CDC)在国家公共卫生体系和人类健康共同体建设中具有重要地位和作用。建设一批中国特色的高水平公共卫生学院对学院自身发展定位、对各级CDC的建设与发展具有战略意义和重要价值。本文就高水平公共卫生学院在CDC建设中的作用以及面临的机遇和挑战阐述思考。     

The control of formaldehyde vapour in the human anatomy laboratory of a traditionally disadvantaged South African medical school

Formaldehyde vapour monitoring was conducted over the period July 1993 to September 1995 in the Human Anatomy Laboratory of the Faculty of Medicine; University of Natal. During the initial study, ambient levels of formaldehyde vapour exceeded the American (ACGIH) threshold limit value (TLV). An intervention in the form of ventilation controls was implemented and proved to be effective in reducing formaldehyde vapour levels. Whether that reduction is sufficient to prevent long-term health effects such as neoplasms and sensitisation remains to be established. The use of alternative methods of environmental control of exposures to formaldehyde are discussed and recommendations are made to reduce the exposure of workers in such situations.     

Evaluation of a pilot school programme aimed at the prevention of obesity in children

This paper describes the development, implementation and evaluation of a school- and family-based intervention to prevent obesity in children aged 5-7 years. In addition, the efficacy of three different intervention programmes was compared. Children aged 5-7 years (n=213) were recruited from three primary schools in Oxford and randomly allocated to a control group or one of three intervention groups: nutrition group, physical activity group, and combined nutrition and physical activity group. The setting for the interventions was lunchtime clubs, where an interactive and age-appropriate nutrition and/or physical activity curriculum was delivered. The intervention lasted for 20 weeks over four school terms (approximately 14 months). Children's growth, nutrition knowledge, diet and physical activity were assessed at baseline and at the end of the intervention. Significant improvements in nutrition knowledge were seen in all children (p<0.01) between baseline and post-intervention, and results were highly significant in the nutrition and combined group (p<0.001). Overall, fruit and vegetable intake increased significantly (p<0.01 and <0.05, respectively), with changes seen in fruit consumption in the nutrition group (p<0.05) and the control group (p<0.05) in particular. No significant changes in the rates of overweight and obesity were seen as a result of the intervention. Gender differences were not detected in the majority of assessments and there was no clear effect of programme type per se. This pilot study has demonstrated that school may be a suitable setting for the promotion of healthy lifestyles in children, but requires replication in other social settings. Future initiatives should be long-lasting, multi-faceted and sustainable, involving all children in a school, and should target the whole environment and be behaviourally focused. The ultimate goal of any such programme is to lead to positive behaviour change which will have a beneficial effect on long-term health. Successful targeting of the family remains a challenge to such interventions.