The Impact of School Water, Sanitation, and Hygiene Interventions on the Health of Younger Siblings of Pupils: a Cluster-Randomized Trial in Kenya
The Impact of School Water, Sanitation, and Hygiene Interventions on the Health of Younger Siblings of Pupils: a Cluster-Randomized Trial in Kenya
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DOI：
10.2105/ajph.2013.301412
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发表时间：
2014-01-01
影响因子：
12.7
通讯作者：
Rheingans, Richard
中科院分区：
文献类型：
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作者：
Dreibelbis, Robert;Freeman, Matthew C.;Rheingans, Richard
目标.我们研究了学校用水、环境卫生和个人卫生（WASH）干预措施对学龄儿童的弟弟妹妹中与疟疾相关的结果的影响。我们在2007年至2009年在肯尼亚的185所学校进行了一项随机分组试验。我们根据水的可用性将学校分配到两个研究组中的一个。多水平logistic回归模型，调整基线测量，评估干预组和对照组之间在1周内腹泻患病率和2周内门诊就诊患病率方面的差异，其中5岁以下儿童中至少有一个兄弟姐妹参加了一个项目学校。在缺水的学校中，与对照学校相比，全面的WASH改善与腹泻的几率降低（比值比[OR] = 0.44; 95%置信区间[CI] = 0.27，0.73）和去诊所就诊（OR = 0.36; 95% CI = 0.19，0.68）相关。在我们的单独研究组中，学校的水供应量更大，学校卫生宣传和水处理干预以及学校卫生设施的改善与干预学校和对照学校之间腹泻患病率的差异无关。在缺水地区，学校讲卫生运动的干预措施，包括大力改善供水，可以减少幼儿中的疟疾。
Objectives. We examined the impact of school water, sanitation, and hygiene (WASH) interventions on diarrhea-related outcomes among younger siblings of school-going children.Methods. We conducted a cluster-randomized trial among 185 schools in Kenya from 2007 to 2009. We assigned schools to 1 of 2 study groups according to water availability. Multilevel logistic regression models, adjusted for baseline measures, assessed differences between intervention and control arms in 1-week period prevalence of diarrhea and 2-week period prevalence of clinic visits among children younger than 5 years with at least 1 sibling attending a program school.Results. Among water-scarce schools, comprehensive WASH improvements were associated with decreased odds of diarrhea (odds ratio [OR] = 0.44; 95% confidence interval [CI] = 0.27, 0.73) and visiting a clinic (OR = 0.36; 95% CI = 0.19, 0.68), relative to control schools. In our separate study group of schools with greater water availability, school hygiene promotion and water treatment interventions and school sanitation improvements were not associated with differences in diarrhea prevalence between intervention and control schools.Conclusions. In water-scarce areas, school WASH interventions that include robust water supply improvements can reduce diarrheal diseases among young children.