Naser Abu Mohd, Unicomb Leanne, Doza Solaiman, Ahmed Kazi Matin, Rahman Mahbubur, Uddin Mohammad Nasir, Quraishi Shamshad B, Selim Shahjada, Shamsudduha Mohammad, Burgess William, Chang Howard H, Gribble Matthew O, Clasen Thomas F, Luby Stephen P
Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Environmental Health & Interventions Unit, Enteric and Respiratory Infections Program, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
BMJ Open. 2017 Sep 1;7(9):e015205. doi: 10.1136/bmjopen-2016-015205.
Saltwater intrusion and salinisation have contributed to drinking water scarcity in many coastal regions globally, leading to dependence on alternative sources for water supply. In southwest coastal Bangladesh, communities have few options but to drink brackish groundwater which has been associated with high blood pressure among the adult population, and pre-eclampsia and gestational hypertension among pregnant women. Managed aquifer recharge (MAR), the purposeful recharge of surface water or rainwater to aquifers to bring hydrological equilibrium, is a potential solution for salinity problem in southwest coastal Bangladesh by creating a freshwater lens within the brackish aquifer. Our study aims to evaluate whether consumption of MAR water improves human health, particularly by reducing blood pressure among communities in coastal Bangladesh.
The study employs a stepped-wedge cluster-randomised controlled community trial design in 16 communities over five monthly visits. During each visit, we will collect data on participants' source of drinking and cooking water and measure the salinity level and electrical conductivity of household stored water. At each visit, we will also measure the blood pressure of participants ≥20 years of age and pregnant women and collect urine samples for urinary sodium and protein measurements. We will use generalised linear mixed models to determine the association of access to MAR water on blood pressure of the participants.
The study protocol has been reviewed and approved by the Institutional Review Boards of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b). Informed written consent will be taken from all the participants. This study is funded by Wellcome Trust, UK. The study findings will be disseminated to the government partners, at research conferences and in peer-reviewed journals.
NCT02746003; Pre-results.
海水入侵和盐碱化导致全球许多沿海地区饮用水短缺，促使人们依赖其他水源供应。在孟加拉国西南沿海地区，社区别无选择，只能饮用微咸的地下水，而这与成年人群的高血压以及孕妇的先兆子痫和妊娠期高血压有关。有管理的含水层补给（MAR），即将地表水或雨水有目的地回灌到含水层以实现水文平衡，是通过在微咸含水层中形成淡水透镜体来解决孟加拉国西南沿海地区盐碱化问题的一种潜在方案。我们的研究旨在评估饮用经有管理的含水层补给处理的水是否能改善人类健康，特别是能否降低孟加拉国沿海社区居民的血压。
本研究采用阶梯式楔形整群随机对照社区试验设计，在16个社区进行为期五个月的随访。每次随访时，我们将收集参与者饮用和烹饪用水的来源数据，并测量家庭储存水的盐度水平和电导率。每次随访时，我们还将测量20岁及以上参与者和孕妇的血压，并采集尿液样本进行尿钠和蛋白质测量。我们将使用广义线性混合模型来确定获取经有管理的含水层补给处理的水与参与者血压之间的关联。
本研究方案已由孟加拉国腹泻病研究国际中心（icddr，b）的机构审查委员会审核并批准。将获取所有参与者的知情书面同意书。本研究由英国惠康信托基金会资助。研究结果将传达给政府合作伙伴、在研究会议上公布并发表在同行评审期刊上。
NCT02746003；预结果。
