Water and hygiene interventions to reduce diarrhoea in rural Afghanistan: a randomized controlled study
Water and hygiene interventions to reduce diarrhoea in rural Afghanistan: a randomized controlled study
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DOI：
10.2166/wh.2010.121
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发表时间：
2010-01-01
影响因子：
2.3
通讯作者：
Burnham, Gilbert
中科院分区：
文献类型：
--
作者：
Opryszko, Melissa C.;Majeed, Sayed Waheedullah;Burnham, Gilbert
进行了一项随机对照试验，包括四种干预措施，使用管井（n = 2，486），液体次氯酸钠（'Clorin'）与改进的水容器一起分发（n = 2，305），卫生宣传（n = 1，877）以及三者结合（n = 2，040），为阿富汗的水政策建立证据基础。第五组作为对照组（n = 2，377）。干预措施在瓦尔达克省的32个村庄随机进行。通过相隔一年的两次住户调查和在16个月内进行的每周两次住户监测来衡量结果。通过纵向监测数据（IRR [95%CI] = 0.61 [0.47-0.81]）和横断面调查数据（AOR [95%CI] = 0.53 [0.30-0.93]），接受所有三种干预措施的家庭与对照组相比腹泻减少。如果将所有家庭成员都包括在内，这一下降幅度很大，但如果只考虑五岁以下儿童，则没有达到显著水平。这些结果表明，多屏障方法是必要的，有很多机会的水污染。监测数据表明，干预措施对减少肠道疾病的影响大于调查数据。通过家庭资产衡量的较高经济地位与较低的腹泻发病率和较高的干预措施摄取率相关，但Clorin除外。使用肥皂也与较低的腹泻患病率有关。
A randomized controlled trial of four interventions was conducted using tubewells (n = 2,486), liquid sodium hypochlorite ('Clorin') distributed with an improved water vessel (n = 2,305), hygiene promotion (n = 1,877), and a combination of the three (n = 2,040) to create an evidence-base for water policy in Afghanistan. A fifth group served as a control (n = 2,377). Interventions were randomized across 32 villages in Wardak province. Outcomes were measured through two household surveys separated by one year and twice-weekly household surveillance conducted over 16 months. The households receiving all three interventions showed reduction in diarrhoea compared with the control group, through both longitudinal surveillance data (IRR [95% CI] = 0.61 [0.47-0.81]) and cross-sectional survey data (AOR [95% CI] = 0.53 [0.30-0.93]). This reduction was significant when all household members were included, but did not reach significance when only children under five were considered. These results suggest multi-barrier methods are necessary where there are many opportunities for water contamination. Surveillance data suggested a greater impact of interventions on reducing diarrhoeal diseases than data from the surveys. Higher economic status as measured through household assets was associated with lower rates of diarrhoea and greater intervention uptake, excepting Clorin. Use of soap was also associated with lower prevalence of diarrhoea.