Background - Acute Enteric Infections (AEI) constitute a major cause of morbidity among children under 5 years of age globally. Preschool educational institutions (PEIs) are frequent hotspots for outbreaks due to high population density and the shared use of sanitary facilities and toys. Objective: To investigate the impact of a structured hygienic education program on the incidence of acute enteric infections and the formation of personal hygiene skills among preschool children. Methods - A cluster-randomized controlled trial was conducted in 12 preschool institutions involving 600 children aged 3–6 years. The institutions were randomly assigned to an Intervention Group (n=6, implementing the "Clean Hands, Healthy Kids" program) or a Control Group (n=6, standard curriculum). The primary outcome was the incidence rate of AEI episodes over a 9-month period. Secondary outcomes included scores on hygiene behavior assessments. Results - The incidence of AEI in the Intervention Group was significantly lower (4.2 episodes per 100 child-years) compared to the Control Group (12.8 episodes per 100 child-years), representing a risk reduction of 67% (p < 0.001). Hygiene compliance scores improved by 55% in the intervention group versus 10% in the control group. Conclusion - Implementation of interactive hygienic education programs significantly reduces the burden of acute enteric infections in preschool settings. Such programs are a critical non-pharmaceutical intervention for public health security in child collectives.

Acute enteric infections, diarrhea, preschool children, hygienic education, handwashing, prevention, public health.

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