Diarrhoea, Nutritional Status, Soil-transmitted Helminth Infection
Conditions
Brief summary
The study is a cluster-randomized, controlled trial conducted among 100 villages (including approximately 3500 households and 20,000 people) in Puri district, State of Orissa, India. The study aims to assess the impact of the construction and use of latrines in rural settings on diarrhoeal disease, helminth infections and nutritional status. The study will also report on the cost and cost-effectiveness of the intervention and its impact on lost days at school and work as well as on expenditures on drugs and medical treatment. The study will document how the intervention actually impacts exposure to human excreta along principal transmission pathways by evaluating the impact on (i) faecal contamination of drinking water, (ii) the presence of mechanical vectors (flies) in food preparation areas, and (iii) the presence of faeces in and around participating households and villages. The study will also explore the extent to which different levels of acquisition and use of on-site sanitation among householders impact disease throughout the community.
Interventions
BEHAVIORALProvision of household latrines
WaterAid and local NGO partners mobilize householders in target villages to construct and use latrines in accordance with the Government of India's Total Sanitation Campaign.
Sponsors
WaterAid
Xavier Institute of Management, Bhubaneswar
Bill and Melinda Gates Foundation
International Initiative for Impact Evaluation
Department for International Development, United Kingdom
University of California, Davis
Emory University
Asian Institute of Public Health
Kalinga Institute of Industrial Technology
London School of Hygiene and Tropical Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
Village level: * Little existing sanitation coverage (\<10%) * WaterAid and implementing partners expects normal scale up * Stable and reasonably acceptable water supply * No other WASH interventions planned or anticipated in next 30 months * Reasonable year-round access by road to permit household visits by surveillance staff Household level: * Presence of a child\<4 or a pregnant woman * Consent to participate * Reside permanently in the village
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diarrhoea (<5s) | 21 months | Longitudinal prevalence of diarrhoea (7-day period prevalence) measured repeatedly every 3 months over a 21-month follow-up period. Diarrhoea is defined according to the WHO definition (three of more stools passed in 24 hrs) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| bacteriological water quality | 21 months | — |
| fly counts | 21 months | — |
| Height-for-age | baseline and endline | Recumbent length measured for children \<2 at baseline and endline following standardised procedures for anthropometric assessment. |
| Soil-transmitted helminth infection | baseline and endline | Prevalence of soil-transmitted helminth infection at the end of the follow-up period |
| latrine coverage and use | 21 months | — |
| lost days at school and work | 21 months | — |
| healthcare expenditure | 21 months | — |
| Diarrhoea (all ages) | 21 months | Longitudinal prevalence of diarrhoea (7-day period prevalence) measured repeatedly every 3 months over a 21-month follow-up period. Diarrhoea is defined according to the WHO definition (passage of three or more loose stools in 24 hrs). |
| Weight-for-age (<5s) | 21 months | Weight of children \<5 is recorded at each diarrhoea surveillance visit (every 3 months over the 21-month follow-up). Weight-for-age Z (WAZ) scores are calculated using the WHO growth standards. WAZ is used a proxy indicator of recent diarrhoea. |
Countries
India
Outcome results
None listed