Reducing Infectious Morbidity and Accelerating Linear Growth among Low Birth Weight Infants with Hand Sanitizers and Nutrition and Hygiene Education in Rural Bangladesh

Abstract

ObjectiveTo investigate if use of water‐based hand sanitizer along with nutrition and hygiene education can prevent linear growth faltering among term, low birth weight (TLBW) infants in Bangladesh.MethodsCommunity‐based, cluster randomized, controlled trial using 48 clusters randomly assigned to two groups: i) Nutrition and Hygiene Education (NHE) plus directed use of Benzalkonium Chloride‐based Hand Sanitizers (HS) by mothers and other family members; ii) NHE only. We followed 467 TLBW infants for 6 months with weekly morbidity and monthly anthropometry.ResultsAt enrolment, mean ± SD anthropometric measures were comparable between HS and NHE groups (birth weight: 2.27±0.2 vs. 2.26±0.2 kg; and birth length: 44.2±1.8 vs. 43.8±1.9 cm). Although results at 1 month postpartum showed no difference in anthropometry between groups, infants in the HS group had reduced rates of skin lesions (12.6% vs.19.4%); infected umbilicus (0.8% vs. 1.4%) and eye infections (0.0% vs. 2.1%) compared to the NHE group. Reported household expenditure on care seeking due to neonatal illness was significantly less in the HS group than that of the NHE group (P<0.009). These preliminary findings suggest a positive effect of hand sanitizer on morbidity at 1 month in term, low birth weight, rural Bangladeshi infants. Funding: Bill & Melinda Gates Foundation to FHI 360, through the Alive & Thrive Small Grants Program managed by UC Davis.Grant Funding Source : Alive and Thrive Small Grants Program, managed by UC Davis