Muriithi Betty, Wandera Ernest Apondi, Takeuchi Rie, Mutunga Felix, Kathiiko Cyrus, Wachira Mary, Tinkoi Joseph, Meiguran Mirasine, Akumu Pius, Ndege Valeria, Mochizuki Ryoichiro, Kaneko Satoshi, Morita Kouichi, Ouma Collins, Ichinose Yoshio
Institute of Tropical Medicine, Nagasaki University-Kenya Medical Research Institute, P.O. Box 19993-00202, Nairobi, Kenya.
Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
Trop Med Health. 2024 Aug 30;52(1):56. doi: 10.1186/s41182-024-00616-1.
Water, sanitation and hygiene (WASH) and child health interventions are proven simple and cost-effective strategies for preventing diarrhea and minimizing excess mortality. Individually, they are able to prevent diarrhea though sub-optimally, and their effectiveness when combined may be higher. This study examined the effect of integrated WASH and maternal and child health (MCH) interventions on prevalence of diarrhea, in a resource-limited setting in Kenya.
A controlled intervention was implemented in Narok County. The interventions included WASH interventions integrated with promotion of MCH. A structured questionnaire was used to collect data on targeted indicators before and after the interventions. Data were analyzed using descriptive statistics and Chi-square to establish the impact of the interventions.
A total of 431and 424 households and 491 and 487 households in intervention and control sites, respectively, participated in the baseline and endline surveys. Following implementation of the interventions, prevalence of diarrhea decreased by 69.1% (95% CI: 49.6-87.1%) and 58.6% (95% CI: 26.6-82.4%) in the intervention and control site, respectively. Treatment of drinking water and animal husbandry practices were significantly associated with diarrhea post-interventions.
Integrating WASH interventions with other diarrhea control strategies and contextualizing them to meet site-specific needs may effectively prevent diarrhea.
水、环境卫生与个人卫生（WASH）以及妇幼保健干预措施是经证实的预防腹泻和将超额死亡率降至最低的简单且具成本效益的策略。单独来看，它们虽能预防腹泻但效果欠佳，而联合使用时效果可能更佳。本研究在肯尼亚资源有限的环境中，考察了综合的水、环境卫生与个人卫生以及妇幼保健（MCH）干预措施对腹泻患病率的影响。
在纳罗克县实施了一项对照干预。干预措施包括与促进妇幼保健相结合的水、环境卫生与个人卫生干预。在干预前后，使用结构化问卷收集关于目标指标的数据。使用描述性统计和卡方检验分析数据，以确定干预措施的影响。
干预组和对照组分别有431户和424户家庭以及491户和487户家庭参与了基线调查和终期调查。实施干预措施后，干预组和对照组的腹泻患病率分别下降了69.1%（95%置信区间：49.6 - 87.1%）和58.6%（95%置信区间：26.6 - 82.4%）。干预后，饮用水处理和畜牧 practices 与腹泻显著相关。
将水、环境卫生与个人卫生干预措施与其他腹泻控制策略相结合，并根据具体地点的需求进行调整，可能有效预防腹泻。
