{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:17:26Z","timestamp":1777432646542,"version":"3.51.4"},"reference-count":68,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,11,27]]},"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6\u2005months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2\u2005years after the first albendazole distribution; and midpoints are measured at 6\u2005months intervals (12\u2005months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health\u2014Project grant from the National Health and Research Council (NHMRC), Australia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ACTRN12614000680662; Pre-results<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009293","type":"journal-article","created":{"date-parts":[[2015,12,30]],"date-time":"2015-12-30T21:43:46Z","timestamp":1451511826000},"page":"e009293","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol"],"prefix":"10.1136","volume":"5","author":[{"given":"Susana Vaz","family":"Nery","sequence":"first","affiliation":[{"name":"Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Traub","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross M","family":"Andrews","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Black","sequence":"additional","affiliation":[{"name":"Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darren","family":"Gray","sequence":"additional","affiliation":[{"name":"Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund","family":"Weking","sequence":"additional","affiliation":[{"name":"WaterAid Australia, Timor-Leste"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo-An","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Sax Institute, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzy","family":"Campbell","sequence":"additional","affiliation":[{"name":"Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Francis","sequence":"additional","affiliation":[{"name":"Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Vallely","sequence":"additional","affiliation":[{"name":"Kirby Institute for Infection and Immunity in Society, University of New South Wales, Kensington, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gail","family":"Williams","sequence":"additional","affiliation":[{"name":"School of Public Health, The University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Archie","family":"Clements","sequence":"additional","affiliation":[{"name":"Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,12,30]]},"reference":[{"key":"2025101813381704000_5.12.e009293.1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-3305-7-37"},{"key":"2025101813381704000_5.12.e009293.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68653-4"},{"key":"2025101813381704000_5.12.e009293.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.1999.00410.x"},{"key":"2025101813381704000_5.12.e009293.4","doi-asserted-by":"publisher","DOI":"10.1017\/S0031182000006491"},{"key":"2025101813381704000_5.12.e009293.5","doi-asserted-by":"crossref","first-page":"540","DOI":"10.4269\/ajtmh.2005.72.540","article-title":"Helminth infection and cognitive impairment among Filipino children","volume":"72","author":"Ezeamama","year":"2005","journal-title":"Am J Trop Med Hyg"},{"key":"2025101813381704000_5.12.e009293.6","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1128\/CMR.10.1.67","article-title":"Waterborne protozoan pathogens","volume":"10","author":"Marshall","year":"1997","journal-title":"Clin Microbiol Rev"},{"key":"2025101813381704000_5.12.e009293.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2005.02.006"},{"key":"2025101813381704000_5.12.e009293.8","doi-asserted-by":"publisher","DOI":"10.1097\/00001432-200310000-00012"},{"key":"2025101813381704000_5.12.e009293.9","first-page":"97","article-title":"World Health Organization\/Pan American Health Organization\/UNESCO report of a consultation of experts on amoebiasis","volume":"72","author":"WHO","year":"1997","journal-title":"Wkly Epidemiol Rec"},{"key":"2025101813381704000_5.12.e009293.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70772-8"},{"key":"2025101813381704000_5.12.e009293.11","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.pt.2003.09.005","article-title":"Drugs for the control of parasitic diseases: current status and development in schistosomiasis","volume":"19","author":"Fenwick","year":"2003","journal-title":"Tends Parasitol"},{"key":"2025101813381704000_5.12.e009293.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7412.431"},{"key":"2025101813381704000_5.12.e009293.13","first-page":"729","article-title":"Ascariasis, trichuriasis, and growth of schoolchildren in Northeastern Peninsular Malaysia","volume":"29","author":"Raj","year":"1998","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"2025101813381704000_5.12.e009293.14","doi-asserted-by":"crossref","first-page":"791","DOI":"10.4269\/ajtmh.1998.59.791","article-title":"The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides","volume":"59","author":"Hadidjaja","year":"1998","journal-title":"Am J Trop Med Hyg"},{"key":"2025101813381704000_5.12.e009293.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0262.2004.00481.x"},{"key":"2025101813381704000_5.12.e009293.16","unstructured":"WHO. Prevention and control of Schistosomiasis and soil-transmitted helminthiasis. Report of a WHO Expert Committee. Technical Report Series No 912. Geneva: World Health Organization, 2002."},{"key":"2025101813381704000_5.12.e009293.17","unstructured":"WHO. Helminth control in school-age children: a guide for managers of control programmes. 2nd edn. Geneva: WHO, 2011."},{"key":"2025101813381704000_5.12.e009293.18","unstructured":"WHO. Eliminating soil-transmitted helminthiasies as a public health problem in children. Progress report 2001\u20132010 and strategic plan 2011\u20132020. WHO, 2012."},{"key":"2025101813381704000_5.12.e009293.19","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro962"},{"key":"2025101813381704000_5.12.e009293.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.pt.2006.02.015"},{"key":"2025101813381704000_5.12.e009293.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2008.05.022"},{"key":"2025101813381704000_5.12.e009293.22","first-page":"563","article-title":"Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia","volume":"28","author":"Norhayati","year":"1997","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"2025101813381704000_5.12.e009293.23","doi-asserted-by":"publisher","DOI":"10.1017\/S0031182000067123"},{"key":"2025101813381704000_5.12.e009293.24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001621"},{"key":"2025101813381704000_5.12.e009293.25","first-page":"216","article-title":"Reinfection and infection rates of soil-transmitted-helminths in Kemiri Sewu, Yogyakarta, Indonesia","volume":"22","author":"Soeripto","year":"1991","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"2025101813381704000_5.12.e009293.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2004.08.001"},{"key":"2025101813381704000_5.12.e009293.27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002651"},{"key":"2025101813381704000_5.12.e009293.28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002439"},{"key":"2025101813381704000_5.12.e009293.29","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(04)01253-8"},{"key":"2025101813381704000_5.12.e009293.30","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyq035"},{"key":"2025101813381704000_5.12.e009293.31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001620"},{"key":"2025101813381704000_5.12.e009293.32","first-page":"609","article-title":"Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma","volume":"69","author":"Esrey","year":"1991","journal-title":"Bull World Health Organ"},{"key":"2025101813381704000_5.12.e009293.33","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-706X(03)00060-3"},{"key":"2025101813381704000_5.12.e009293.34","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001162"},{"key":"2025101813381704000_5.12.e009293.35","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.046045"},{"key":"2025101813381704000_5.12.e009293.36","first-page":"512","article-title":"Design and implementation of participatory hygiene and sanitation transformation (PHAST) as a strategy to control soil-transmitted helminth infections in Luweero, Uganda","volume":"13","author":"Dumba","year":"2013","journal-title":"Afr Health Sci"},{"key":"2025101813381704000_5.12.e009293.37","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.13-0237"},{"key":"2025101813381704000_5.12.e009293.38","doi-asserted-by":"crossref","first-page":"e2621","DOI":"10.1371\/journal.pntd.0002621","article-title":"School-based health education targeting intestinal worms-further support for integrated control","volume":"8","author":"Bieri","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"2025101813381704000_5.12.e009293.39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002397"},{"key":"2025101813381704000_5.12.e009293.40","doi-asserted-by":"crossref","first-page":"e1001837","DOI":"10.1371\/journal.pmed.1001837","article-title":"Efficacy of handwashing with soap and nail clipping on intestinal parasitic infections in school-aged children: a factorial cluster randomized controlled trial","volume":"12","author":"Mahmud","year":"2015","journal-title":"PLoS Med"},{"key":"2025101813381704000_5.12.e009293.41","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70307-9"},{"key":"2025101813381704000_5.12.e009293.42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001709"},{"key":"2025101813381704000_5.12.e009293.43","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003476"},{"key":"2025101813381704000_5.12.e009293.44","unstructured":"Anon. Timor-Leste: poverty in a young nation. Dili: Directorate of National Statistics, Ministry of Finance, 2008."},{"key":"2025101813381704000_5.12.e009293.45","unstructured":"WHO GHORDot. Probability of dying per 1 000 live births Data by WHO region. WHO. http:\/\/apps.who.int\/gho\/data\/view.main.CM1300R?lang=en ."},{"key":"2025101813381704000_5.12.e009293.46","unstructured":"WHO GHORDot. Probability of dying per 1 000 live births Data by country. Secondary Probability of dying per 1 000 live births Data by country. http:\/\/apps.who.int\/gho\/data\/view.main.CM1320R?lang=en"},{"key":"2025101813381704000_5.12.e009293.47","unstructured":"Ministry of Health NSD, Ministry of Finance (Timor-Leste), and ICF MAcro. Timor-Leste Demographic and Health Survey 2009\u201310. Dili, Timor-Leste: NSD Timor-Leste and ICF Macro, 2010."},{"key":"2025101813381704000_5.12.e009293.48","unstructured":"Martins N , McMinn P . Timor-Leste national parasite survey. Dili: Timor-Leste Ministry of Health, 2012."},{"key":"2025101813381704000_5.12.e009293.49","unstructured":"Ministry of Health. A plan for an integrated neglected tropical disease control in Timor-Leste, 2014\u20132020. Dili: Ministry of Health, 2013."},{"key":"2025101813381704000_5.12.e009293.50","unstructured":"WaterAid. Training manual\u2014water resource management: integrated planning and management at community level. Nepal: WaterAid, 2011."},{"key":"2025101813381704000_5.12.e009293.51","unstructured":"Kar K . Practical Guide to Triggering Community-Led Total Sanitation (CLTS). Institute of Development Studies, 2005."},{"key":"2025101813381704000_5.12.e009293.52","unstructured":"Kar K , Chambers R . Handbook on community-led total sanitation. Plan International (UK) IfDSatUoSU, 2008."},{"key":"2025101813381704000_5.12.e009293.53","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.16.1937"},{"key":"2025101813381704000_5.12.e009293.54","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.vetpar.2008.11.022","article-title":"Effect of storage media, temperature, and time on preservation of Cryptosporidium parvum oocysts for PCR analysis","volume":"160","author":"Lalonde","year":"2009","journal-title":"Vet Parasitol"},{"key":"2025101813381704000_5.12.e009293.55","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.mimet.2009.06.018","article-title":"Preservation of Giardia cysts in stool samples for subsequent PCR analysis","volume":"78","author":"Wilke","year":"2009","journal-title":"J Microbiol Methods"},{"key":"2025101813381704000_5.12.e009293.56","doi-asserted-by":"crossref","first-page":"539","DOI":"10.4269\/ajtmh.2002.67.539","article-title":"The role of dogs in transmission of gastrointestinal parasites in a remote tea-growing community in northeastern India","volume":"67","author":"Traub","year":"2002","journal-title":"Am J Trop Med Hyg"},{"key":"2025101813381704000_5.12.e009293.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.vetpar.2004.05.026"},{"key":"2025101813381704000_5.12.e009293.58","doi-asserted-by":"crossref","first-page":"e3313","DOI":"10.1371\/journal.pntd.0003313","article-title":"Simple fecal flotation is a superior alternative to guadruple Kato Katz smear examination for the detection of hookworm eggs in human stool","volume":"8","author":"Inpankaew","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"2025101813381704000_5.12.e009293.59","doi-asserted-by":"crossref","first-page":"976","DOI":"10.3201\/eid2006.131770","article-title":"High prevalence of Ancylostoma ceylanicum hookworm infections in humans, Cambodia, 2012","volume":"20","author":"Inpankaew","year":"2014","journal-title":"Emerg Infect Dis"},{"key":"2025101813381704000_5.12.e009293.60","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2011.10-0499"},{"key":"2025101813381704000_5.12.e009293.61","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.3.1220-1223.2004"},{"key":"2025101813381704000_5.12.e009293.62","unstructured":"WHO. Iron deficiency anaemia: assessment, prevention and control. Geneva: World Health Organisation, 2001."},{"key":"2025101813381704000_5.12.e009293.63","first-page":"625","article-title":"Altitude correction for hemoglobin","volume":"48","author":"Dirren","year":"1994","journal-title":"Eur J Clin Nutr"},{"key":"2025101813381704000_5.12.e009293.64","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1093\/ajcn\/64.4.650","article-title":"Anthropometric reference data for international use: recommendations from a WHO Expert Committee","volume":"64","author":"de Onis","year":"1996","journal-title":"Am J Clin Nutr"},{"key":"2025101813381704000_5.12.e009293.65","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1519"},{"key":"2025101813381704000_5.12.e009293.66","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg074"},{"key":"2025101813381704000_5.12.e009293.67","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"2025101813381704000_5.12.e009293.68","unstructured":"Stata Statistical Software: Release 13 [program]. TX: College Station, StataCorp LP, 2013."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-009293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:38:28Z","timestamp":1760819908000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-009293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":68,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2015,12,30]]},"published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1136\/bmjopen-2015-009293"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-009293","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12]]}}}