Effectiveness of a Household Water, Sanitation and Hygiene Package on an Outpatient Program for Severe Acute Malnutrition: A Pragmatic Cluster-Randomized Controlled Trial in Chad

The American Journal of Tropical Medicine and Hygiene
Mathias AltmannPatrick Kolsteren

Abstract

Water, sanitation and hygiene (WASH) interventions have a small but measurable benefit on stunting, but not on wasting. Our objective was to assess the effectiveness of a household WASH package on the performance of an Outpatient Therapeutic feeding Program (OTP) for severe acute malnutrition (SAM). We conducted a cluster-randomized controlled trial embedded in a routine OTP. The study population included 20 health centers (clusters) from Mao and Mondo districts in Chad. Both arms received the OTP. The intervention arm received an additional household WASH package (chlorine, soap, water storage container, and promotion on its use). The primary objective measures were the relapse rates to SAM at 2 and 6 months post-recovery. The secondary objectives included the recovery rate from SAM, the time-to-recovery, the weight gain, and the diarrhea longitudinal prevalence in OTP. The study lasted from April 2015 to May 2016. Among the 1,603 recruited children, 845 were in the intervention arm and 758 in the control arm. No differences in the relapse rates were noticed at 2 (-0.4%; P = 0.911) and 6 (-1.0%; P = 0.532) months. The intervention decreased the time-to-recovery (-4.4 days; P = 0.038), improved the recovery rate (10.5%; P = 0.0...Continue Reading

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Citations

Sep 25, 2019·The Cochrane Database of Systematic Reviews·Fiona MajorinThomas Clasen
Nov 5, 2020·Maternal & Child Nutrition·Robin SchaeferRobert Black
Feb 1, 2021·The American Journal of Clinical Nutrition·Christie C A NobleAndrew J Prendergast

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Clinical Trials Mentioned

NCT02486523

Software Mentioned

STATA

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