1. STAC36 - March 2014
Design and Evaluation of a Health Educational Board Game for the Control of Soil Transmitted Helminthiasis among Primary School Children in Abeokuta, Nigeria.
1 UF Ekpo, 1DB Olabinke, 1 GA Dedeke, 2BI Akeredolu-Ale 1Dept. of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria;  2 Dept. of Communication and Language studies, Federal University of Agriculture, Abeokuta, Nigeria.
Contact Address:
Spatial Parasitology and Health GIS unit,
Department of Pure and Applied Zoology,
Federal University of Agriculture, Abeokuta, Nigeria.
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2. SOIL TRANSMITTED HELMINTHS (STH)
STH are the most common Neglected Tropical Diseases (NTDs).
Over 5 billion people are at risk of acquiring an infection with Ascaris lumbricoides, hookworm, or Trichuris trichiura (the most common STH) and over a billion people are currently infected (Pullan et al., 2014).
The transmission of STH is governed by social-ecological systems, (Bethony et al., 2006).
Nigeria is the leading country for high burden of STH in Sub Saharan Africa ( Hotez et al., 2012).
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3. THE PROBLEM
Despite treatment regimen in school- aged children, infection reaches pre- treatment levels in as few as six weeks and 94% after twelve months.
Health education that improves knowledge about STH and promotes good hygiene practices and prevent reinfection have been advocated as a complementary strategy during deworming exercise.
However, current health education strategies are not user-friendly to school aged children in Nigeria.
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4. OBJECTIVE OF THIS STUDY
To design and evaluate an educational board game and evaluate its potential to reduce reinfection with STH after deworming exercise in Nigeria.
We used games as a tool that can improve knowledge about STH and promotes good hygiene practices among school aged children in Ogun State.
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5. Methods-The Game
At first, we developed a new health educational board game : “Worms and Ladder”
“In the designing,
We considered the risk factors for STH (through review of previous epidemiological studies conducted among children)”
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6. Methods Study protocols
Then, we moved forward by evaluating its potential for promoting good hygiene practices among school children for the control of STH.
Study protocols
Study design – Randomized Control Design
Study sites: Six schools in Abeokuta, Ogun State. ?? Name of schools
Three schools in the intervention group and Three schools in the control group.
Intervention group received the newly developed game to play for 6 months
Control group received none
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7. Study flow chart
Enrollment of Study Participants
Baseline KAP survey and screening of stool samples for STH
Deworming of School Children including study participants
Randomization of school into treatment groups
Follow-up KAP assessment and prevalence survey (3 and 6 months interval)
“Structured questionnaire were used to assess knowledge, attitude and practices (KAP) as regards STH infections.
Single stool sample was collected and screened for STH infections, followed by treatment with albendazole (400mg).
Efficacy of treatment was monitored over 7 days to ensure that all participants were worm-free.
‘Worms and Ladders’ game were given to the intervention group to play during break under the supervision of teachers for 6 months administration.
The pupils were re-examined for STH infections and KAP after three and six months post treatment and follow-up visits.
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8. RESULTS Overview of the study participants Group Frequency (%)
Intervention group
212 (56.9)
Control group
160 (43.1)
Total
372 (100%)
A total of 372 pupils enrolled in the study of which 212 were in the intervention group in three schools, and 160 were in the control group in three schools.
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9. PREVALENCE OF STH
Prevalence of STH dropped from 25.0% to 10.4% in the intervention group and 49.4% to 33.3% in the control group at three months post treatment.
It further dropped to 5.6% in the intervention group but increased to 37.2% in the control group at six months post treatment.
There was a significant difference (p<0.05) in post-treatment prevalence among the two groups.
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10. PREVALENCE BY AGE GROUP
KAP on transmission, control and prevention of STH significantly improved (p<0.05) from 5.2% to 97.9% in the intervention group compared to (6.2% to 7.1%) in the control group.
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11. IMPLICATIONS Implication of our findings
This study has shown that our designed “Worms and Ladders” game has the potential for teaching basic hygiene education and promoting behavioural changes among school children
It can serve as a companion tool for distribution during MDA activities in schools.
Future activity
Further RCTs in other parts of Nigeria.
Potential of conversion into smart phone apps
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12. 54th BSP Spring Meeting 2016, Imperial College London
Contact Address:
Spatial Parasitology and Health GIS unit,
Department of Pure and Applied Zoology,
Federal University of Agriculture, Abeokuta, Nigeria.
54th BSP Spring Meeting 2016, Imperial College London