Acute Diarrheal Disease, Acute Respiratory Infection
Conditions
Keywords
Health Production, Government Policy; Regulation; Public Health, Government Policy; Provision and Effects of Welfare Programs, Gastrointestinal diseases, Respiratory Tract Infections, Diarrhea, Ethanol, Child, Preschool, Handwashing
Brief summary
The purpose of this study is to conduct a Randomized Control Trial (RCT) in a developing country setting in order to evaluate the role of alcohol based hand sanitizers (ABHS) in preventing the transmission of infectious diseases in areas where water is a scarce resource. The investigators want to find out if the use of ABHS reduces the incidence of two leading causes of morbidity and mortality in children under 5 years of age in the developing world: acute diarrheal disease (ADD) and acute respiratory infections (ARI).
Detailed description
We performed a cluster, RCT in child care centers located in six urban settings of Colombia with intermittent tap water availability. A total of 1727 children between 1 and 5 years of age distributed in 42 childcare centers participated in the study. The intervention consisted on installation of ABHS gel dispensers and training on their use by participating children in child care centers. Centers assigned to the control group were recommended to continue with current hand hygiene practices. Child care centers matched by location, size and sanitary conditions were randomly assigned to intervention or control. Cases of Acute Diarrheal Disease (ADD) and Acute Respiratory Infections ARI were identified through teacher reported signs and symptoms of disease and validated by a trained physician. We also monitored adverse events potentially related to ABHS. To compare incidence rates between study arms we modeled the number of episodes of ADD and ARI per child using a Cox proportional hazards multiple regression with random effects.
Interventions
OTHERABHS use
Centers assigned to the intervention group were provided with ABHS dispensers with a gel solution with ethyl alcohol at 62% as active ingredient (Purell®, GOJO Industries, Dayton, Ohio). A total of 85 dispensers were installed, one dispenser was installed in each center of size less than 14 children, and one per classroom plus an additional one for common areas in centers with more than 28 children. Proper safety measures were followed. Standardized ABHS training workshops for staff and children in centers allocated to the intervention were carried out simultaneously with dispenser installation. Thirty minute refresher sessions about ABHS technique were provided to staff and children on a monthly basis, for a total of 8 sessions per center.
Sponsors
Fedesarrollo
Pontificia Universidad Javeriana
Global Development Network
Fundación Santa Fe de Bogota
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to 5 Years
Healthy volunteers
Yes
Inclusion criteria
* Children between 1 and 5 years of age * Attending child care centers with limited tap water availability
Exclusion criteria
* Chronic conditions * Not willing to participate
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of Cases of Acute Diarrheal Disease Number of Cases of Acute Respiratory Infection | April - December 2008 |
Secondary
| Measure | Time frame |
|---|---|
| Number of Adverse Events | April - December 2008 |
Countries
Colombia
Outcome results
None listed