Jung Sunghoon, Doh Young-Ah, Bizuneh Dawit Belew, Beyene Habtamu, Seong Jieun, Kwon Hyunjin, Kim Yongwhan, Habteyes Girma Negussie, Tefera Yigrem, Cha Seungman
Re-shaping Development Institute, 5 Yangpyeong-ro 12ga-gil, Yeongdeungpo-gu, Seoul, Republic of Korea.
Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do, 13449, Republic of Korea.
Trials. 2016 Apr 18;17(1):204. doi: 10.1186/s13063-016-1319-z.
Diarrhea is one of the leading causes of death, killing 1.3 million in 2013 across the globe, of whom, 0.59 million were children under 5 years of age. Globally, about 1 billion people practice open defecation, and an estimated 2.4 billion people were living without improved sanitation facilities in 2015. Much of the previous research investigating the effect of improved sanitation has been based on observational studies. Recent studies have executed a cluster-randomized controlled trial to investigate the effect of improved sanitation. However, none of these recent studies achieved a sufficient level of latrine coverage. Without universal or at least a sufficient level of latrine coverage, a determination of the effect of improved latrines on the prevention of diarrheal disease is difficult. This cluster-randomized trial aims to explore the net effect of improved latrines on diarrheal prevalence and incidence in children under five and to investigate the effect on the diarrheal duration.
METHOD/DESIGN: A phase-in and factorial design will be used for the study. The intervention for improving latrines will be implemented in an intervention arm during the first phase, and the comparable intervention will be performed in the control arm during the second phase. During the second phase, a water pipe will be connected to the gotts (villages) in the intervention arm. After the second phase is completed, the control group will undergo the intervention of receiving a water pipe connection. For diarrheal prevalence, five rounds of surveying will be conducted at the household level. The first four rounds will be carried out in the first phase to explore the effect of improved latrines, and the last one, in the second phase to examine the combined effects of improved water and sanitation. For documentation of diarrheal incidence and duration, the mother or caregiver will record the diarrheal episodes of her youngest child on the "Sanitation Calendar" every day. Of 212 gotts in the project area, 48 gotts were selected for the trial, and 1200 households with a child under 5 will be registered for the intervention or control arm. Informed consent from 1200 households will be obtained from the mother or caregiver in written form.
To our knowledge, this is the second study to assess the effects of improved latrines on child diarrheal reduction through the application of Community-Led Total Sanitation.
Current Controlled Trials, ISRCTN82492848.
腹泻是主要死因之一，2013年全球有130万人死于腹泻，其中59万是5岁以下儿童。全球约有10亿人露天排便，2015年估计有24亿人生活在没有改善卫生设施的环境中。此前许多研究改善卫生设施效果的研究都是基于观察性研究。最近的研究进行了整群随机对照试验来调查改善卫生设施的效果。然而，这些近期研究都没有达到足够的厕所覆盖率。如果没有普及或至少足够的厕所覆盖率，就很难确定改善厕所对预防腹泻疾病的效果。这项整群随机试验旨在探讨改善厕所对5岁以下儿童腹泻患病率和发病率的净影响，并调查对腹泻持续时间的影响。
方法/设计：本研究将采用分阶段和析因设计。改善厕所的干预措施将在第一阶段在干预组实施，可比干预措施将在第二阶段在对照组实施。在第二阶段，将给干预组的村庄接通水管。第二阶段完成后，对照组将接受接通水管的干预。对于腹泻患病率，将在家庭层面进行五轮调查。前四轮将在第一阶段进行，以探索改善厕所的效果，最后一轮在第二阶段进行，以检验改善水和卫生设施的综合效果。为记录腹泻发病率和持续时间，母亲或照料者将每天在“卫生日历”上记录其最小孩子的腹泻发作情况。在项目区域的212个村庄中，选取48个村庄进行试验，1200户有5岁以下儿童的家庭将登记参加干预组或对照组。将以书面形式从1200户家庭的母亲或照料者处获得知情同意。
据我们所知，这是第二项通过应用社区主导的全面卫生来评估改善厕所对减少儿童腹泻影响的研究。
当前受控试验，ISRCTN82492848。
