Abstract
IntroductionPneumonia and diarrhoea are leading causes of death in children. There is a need to develop effective interventions. ObjectiveWe present the design and baseline findings of a community-randomised controlled trial in rural Peru to evaluate the health impact of an Integrated Home-based Intervention Package in children aged 6 to 35months. MethodsWe randomised 51 communities. The intervention was developed through a community-participatory approach prior to the trial. They comprised the construction of improved stoves and kitchen sinks, the promotion of hand washing, and solar drinking water disinfection (SODIS). To reduce the potential impact of non-blinding bias, a psychomotor stimulation intervention was implemented in the control arm. The baseline survey included anthropometric and socio-economic characteristics. In a sub-sample we determined the level of faecal contamination of drinking water, hands and kitchen utensils and the prevalence of diarrhoegenic Escherichia coli in stool specimen. ResultsWe enrolled 534 children. At baseline all households used open fires and 77% had access to piped water supplies. E. coli was found in drinking water in 68% and 64% of the intervention and control households. Diarrhoegenic E. coli strains were isolated from 45/139 stool samples. The proportion of stunted children was 54%. ConclusionsRandomization resulted in comparable study arms. Recently, several critical reviews raised major concerns on the reliability of open health intervention trials, because of uncertain sustainability and non-blinding bias. In this regard, the presented trial featuring objective outcome measures, a simultaneous intervention in the control communities and a 12-month follow up period will provide valuable evidence.
Highlights
Pneumonia and diarrhoea are leading causes of death in children
They comprised the construction of improved stoves and kitchen sinks, the promotion of hand washing, and solar drinking water disinfection (SODIS)
In a sub-sample we determined the level of faecal contamination of drinking water, hands and kitchen utensils and the prevalence of diarrhoegenic Escherichia coli in stool specimen
Summary
Pneumonia and diarrhoea are leading causes of death in children. There is a need to develop effective interventions. Several critical reviews raised major concerns on the reliability of open health intervention trials, because of uncertain sustainability and non-blinding bias In this regard, the presented trial featuring objective outcome measures, a simultaneous intervention in the control communities and a 12month follow up period will provide valuable evidence. Efficient and effective interventions, such as providing running water within the kitchen area, improving water quality through household water treatment and washing hands using soap are acceptable interventions in most communities. They contribute effectively to the prevention of diarrhoeal diseases and the transmission of acute lower respiratory infection (ALRI) [7,8,9,10]. A recent meta-analysis determined a pooled odds of disease of 1.8 for children exposed to cooking with solid fuels [14,15]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.