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The effects of improved sanitation on diarrheal prevalence, incidence, and duration in children under five in the SNNPR State, Ethiopia: study protocol for a randomized controlled trial.

Jung S, Doh YA, Bizuneh DB, Beyene H, Seong J, Kwon H, Kim Y, Habteyes GN, Tefera Y, Cha S - Trials (2016)

Bottom Line: 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.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.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.

View Article: PubMed Central - PubMed

Affiliation: Re-shaping Development Institute, 5 Yangpyeong-ro 12ga-gil, Yeongdeungpo-gu, Seoul, Republic of Korea.

ABSTRACT

Background: 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.

Discussion: 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.

Trial registration: Current Controlled Trials, ISRCTN82492848.

No MeSH data available.


Related in: MedlinePlus

Project area and study area
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Fig1: Project area and study area

Mentions: The Cheha District and Enemore Ena Ener District, the target area of the project, are located 185 km southwest of Addis Ababa. According to the District Statistics Office, the total population of each district was 133,233 and 204,937, respectively, in 2014. Both districts are predominantly rural areas with 90 % of the entire land used for farming, and the major sources of income are crop production and livestock farming. Coffee, chat, and oil seeds are among the major cash crops in both districts, and plantations of eucalyptus trees for income are also very common. The dominant ethnic group, which accounts for more than 80 % of the population in the area, is the Gurage people, after which the administrative zone of the area is named (Gurage Zone). Of the population in the area, 64 % are Muslim, whereas 33 % identified themselves as Ethiopian Orthodox Christian (Fig. 1).Fig. 1


The effects of improved sanitation on diarrheal prevalence, incidence, and duration in children under five in the SNNPR State, Ethiopia: study protocol for a randomized controlled trial.

Jung S, Doh YA, Bizuneh DB, Beyene H, Seong J, Kwon H, Kim Y, Habteyes GN, Tefera Y, Cha S - Trials (2016)

Project area and study area
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835836&req=5

Fig1: Project area and study area
Mentions: The Cheha District and Enemore Ena Ener District, the target area of the project, are located 185 km southwest of Addis Ababa. According to the District Statistics Office, the total population of each district was 133,233 and 204,937, respectively, in 2014. Both districts are predominantly rural areas with 90 % of the entire land used for farming, and the major sources of income are crop production and livestock farming. Coffee, chat, and oil seeds are among the major cash crops in both districts, and plantations of eucalyptus trees for income are also very common. The dominant ethnic group, which accounts for more than 80 % of the population in the area, is the Gurage people, after which the administrative zone of the area is named (Gurage Zone). Of the population in the area, 64 % are Muslim, whereas 33 % identified themselves as Ethiopian Orthodox Christian (Fig. 1).Fig. 1

Bottom Line: 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.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.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.

View Article: PubMed Central - PubMed

Affiliation: Re-shaping Development Institute, 5 Yangpyeong-ro 12ga-gil, Yeongdeungpo-gu, Seoul, Republic of Korea.

ABSTRACT

Background: 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.

Discussion: 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.

Trial registration: Current Controlled Trials, ISRCTN82492848.

No MeSH data available.


Related in: MedlinePlus