A Randomized Controlled Trial to Measure Spillover Effects of a Combined Water, Sanitation, and Handwashing Intervention in Rural Bangladesh.
A Randomized Controlled Trial to Measure Spillover Effects of a Combined Water, Sanitation, and Handwashing Intervention in Rural Bangladesh.
复制标题
一项随机对照试验，用于测量孟加拉国农村水，卫生和洗手干预的溢出作用。
DOI：
10.1093/aje/kwy046
复制
发表时间：
2018-08-01
影响因子：
5
通讯作者：
Colford JM Jr
中科院分区：
文献类型：
--
作者：
Benjamin-Chung J;Amin N;Ercumen A;Arnold BF;Hubbard AE;Unicomb L;Rahman M;Luby SP;Colford JM Jr
水、卫生和洗手干预措施可能通过阻断病原体传播而对干预措施接受者的邻居产生溢出效应。我们在水质，卫生和洗手（WASH）效益研究中测量了地理上的当地溢出效应，这是一项在孟加拉国农村进行的群集随机试验，通过比较干预邻居与对照参与者的结果。将地理上定义的群组随机分配至化合物水平干预（即，从2015年1月到2015年8月，在180个集群中，我们招募了1，799名与试验参与者年龄匹配的邻居儿童，他们有资格参加这项研究，如果他们怀孕稍早或稍晚。经过28个月的干预，我们量化了玩具冲洗液和饮用水样本中的粪便指示细菌，并测量了土壤传播的蠕虫感染以及腹泻和呼吸道疾病。邻居的特征在手臂上是平衡的。干预参与者邻居的管井样本中可检测到的大肠杆菌患病率低于对照参与者（患病率比= 0.83; 95%置信区间：0.73，0.95）。对于其他环境样本，两组之间的粪便指示细菌患病率没有差异。干预参与者的邻居与对照参与者的土壤传播蠕虫感染、腹泻和呼吸道疾病的患病率相似。复合水平的水，卫生和洗手干预减少了邻居的管井水污染，但不影响邻居儿童的健康。
Water, sanitation, and handwashing interventions may confer spillover effects on intervention recipients’ neighbors by interrupting pathogen transmission. We measured geographically local spillovers in the Water Quality, Sanitation, and Handwashing (WASH) Benefits Study, a cluster-randomized trial in rural Bangladesh, by comparing outcomes among neighbors of intervention versus those of control participants. Geographically defined clusters were randomly allocated to a compound-level intervention (i.e., chlorinated drinking water, upgraded sanitation, and handwashing promotion) or control arm. From January 2015 to August 2015, in 180 clusters, we enrolled 1,799 neighboring children who were age matched to trial participants who would have been eligible for the study had they been conceived slightly earlier or later. After 28 months of intervention, we quantified fecal indicator bacteria in toy rinse and drinking water samples and measured soil-transmitted helminth infections and caregiver-reported diarrhea and respiratory illness. Neighbors’ characteristics were balanced across arms. Detectable Escherichia coli prevalence in tubewell samples was lower for intervention participants’ neighbors than control participants’ (prevalence ratio = 0.83; 95% confidence interval: 0.73, 0.95). Fecal indicator bacteria prevalence did not differ between arms for other environmental samples. Prevalence was similar in neighbors of intervention participants versus those of control participants for soil-transmitted helminth infection, diarrhea, and respiratory illness. A compound-level water, sanitation, and handwashing intervention reduced neighbors’ tubewell water contamination but did not affect neighboring children’s health.
登录
查看更多内容
影响因子：
7.7
作者：
Benjamin-Chung J;Abedin J;Berger D;Clark A;Jimenez V;Konagaya E;Tran D;Arnold BF;Hubbard AE;Luby SP;Miguel E;Colford JM Jr
通讯作者：
Colford JM Jr
影响因子：
4.5
作者：
Dreibelbis R;Winch PJ;Leontsini E;Hulland KR;Ram PK;Unicomb L;Luby SP
通讯作者：
Luby SP
DOI：
10.1016/s0140-6736(15)60095-2
发表时间：
2015-07-11
期刊：
Lancet (London, England)
影响因子：
--
作者：
Kim DA;Hwong AR;Stafford D;Hughes DA;O'Malley AJ;Fowler JH;Christakis NA
通讯作者：
Christakis NA
DOI：
10.1111/tmi.12329
发表时间：
2014-08
期刊：
Tropical medicine & international health : TM & IH
影响因子：
--
作者：
Prüss-Ustün A;Bartram J;Clasen T;Colford JM Jr;Cumming O;Curtis V;Bonjour S;Dangour AD;De France J;Fewtrell L;Freeman MC;Gordon B;Hunter PR;Johnston RB;Mathers C;Mäusezahl D;Medlicott K;Neira M;Stocks M;Wolf J;Cairncross S
通讯作者：
Cairncross S
影响因子：
7.7
作者：
Fuller, James A.;Villamor, Eduardo;Eisenberg, Joseph N. S.
通讯作者：
Eisenberg, Joseph N. S.