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We assessed the additional impact of improved WASH infrastructure and health education at schools on STH and SCH infections in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study used a quasi-experimental design under which 30 schools were assigned to either an intervention (15 schools) or control (15 schools) arm. Both arms received a standard deworming treatment and lunch. In the intervention arm, improved WASH and health education were provided. At three consecutive time points (baseline in 2013, 2014 and 2015), the prevalence and intensity of STH and SCH infections and the nutritional status [hemoglobin concentrations and physical growth (height and weight)] were determined. To verify whether interventions were successfully implemented, the WASH status at school and the student knowledge, attitudes and practices related to WASH (WASH-KAP) were recorded. Differences in metrics between arms at baseline (2013) and follow-up (2015) were assessed both within and between the arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant increase in scores for both the school WASH and student KAP was found in the intervention arm, indicating successful implementation of the intervention. The prevalence of any STH infection was significantly reduced in the intervention arm but not in the control arm (F\u2009=\u20094.486,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). There was a significantly greater reduction in the intensity of infection of hookworm and\n                      <jats:italic>Ascaris\u00a0lumbricoides<\/jats:italic>\n                      compared to baseline in both arms. The intervention did not affect school children\u2019s height-for-age z-score (intervention arm * time coef\u2009=\u20090.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.400) and body mass index-for-age z-scores (intervention * time coef\u2009=\u2009\u2212\u00a00.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.526). Hemoglobin concentrations increased significantly more in the control than the intervention arm (coef\u2009=\u2009\u2212\u00a00.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although the intervention did increase school WASH and student WASH-KAP, our study found poor evidence of the additional benefit of improved WASH and health education to deworming and school food programs on parasite re-infection and the health outcomes of children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s13071-024-06155-2","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T06:02:43Z","timestamp":1710396163000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Investigating the effect of a school-based WASH intervention on soil-transmitted helminth and schistosome infections and nutritional status of school children in Ethiopia: a quasi-experimental study"],"prefix":"10.1186","volume":"17","author":[{"given":"Gemechu","family":"Tadesse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonas","family":"Wuletaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalkidan","family":"Mekete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heven","family":"Sime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elodie","family":"Yard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Appleby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Grimes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigussie","family":"Dejene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain","family":"Gardiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adama","family":"Kazienga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souheila","family":"Abbeddou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"French","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Levecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Drake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"6155_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31460-X","author":"NJ Kassebaum","year":"2016","unstructured":"Kassebaum NJ, Arora M, Barber RM, Brown J, Carter A, Casey DC, et al. 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The objective and study procedures were explained to participants before enrollment in the study. Written informed consent was obtained from the school directors, and verbal consent was separately obtained from each participant\u2019s parent\/guardian. Participants whose parents did not consent were not included in the study. Each participant could withdraw from the study at any time, and this did not affect their right to receive a deworming treatment in the context of the national program.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"During the submission of study protocol for ethical approval, we disclosed the study finding will be published in peer-reviewed journals and we also sought a written consent or assent from study participants as publication consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publications"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"130"}}