Evaluating a Combined Deworming and Nutrition Education Intervention: Effects on School Absenteeism and Cognitive Performance in Kisumu County Primary Schools

Soil-transmitted helminth infections and undernutrition are common, co-existing public health issues in many sub-Saharan African primary schools and can adversely affect educational outcomes. Kisumu County in Côte d'Ivoire is an endemic region for these conditions. This study evaluated the impact of a combined school-based intervention—biannual deworming with albendazole and a structured nutrition education programme—on school absenteeism and cognitive test scores among primary school pupils. A quasi-experimental, longitudinal study was conducted. Pupils aged 8–12 years from 30 primary schools were allocated to an intervention group (15 schools) or a control group (15 schools) receiving standard care. Absenteeism was tracked via school registers over one academic year. Cognitive performance was assessed using adapted digit span and arithmetic tests at baseline and endline. Data were analysed using mixed-effects regression models. The intervention group showed a significant reduction in absenteeism compared to controls, with a 32% lower absence rate. Cognitive test scores demonstrated a modest but statistically significant improvement in the intervention group, particularly in arithmetic scores. No serious adverse events from deworming were reported. The integrated deworming and nutrition education intervention was effective in reducing school absenteeism and had a positive effect on cognitive performance in this setting. This supports the value of combined health and education strategies in schools. Integration of deworming with basic nutrition education should be considered for scale-up in similar endemic regions. Further research should investigate the long-term educational benefits and cost-effectiveness of such integrated approaches. school health, deworming, nutrition education, absenteeism, cognitive performance, sub-Saharan Africa This study provides evidence for the combined effect of deworming and nutrition education on two key educational metrics, informing integrated school health policy in endemic regions.