Sep 22, 2017

Spillover effects of a combined water, sanitation, and handwashing intervention in rural Bangladesh: a randomized controlled trial

BioRxiv : the Preprint Server for Biology
Jade Benjamin-ChungJohn M Colford

Abstract

Background: Water, sanitation, and handwashing (WSH) interventions may confer indirect benefits ("spillovers") on neighbors of recipients by interrupting pathogen transmission. We measured geographically local spillovers in WASH Benefits, a cluster-randomized trial in rural Bangladesh, by comparing outcomes among neighbors of intervention vs. control participants. Methods: WASH Benefits had randomly allocated geographically-defined clusters to a compound-level intervention (chlorinated drinking water, upgraded sanitation, and handwashing promotion) or control and followed children for two years. We enrolled neighboring children age-matched to trial participants that would have been eligible for WASH Benefits had they been conceived slightly earlier or later. After 28 months of intervention, we quantified fecal indicator bacteria in toy rinse and drinking water samples, measured soil-transmitted helminth infections, and recorded caregiver-reported diarrhea and respiratory illness. Neither fieldworkers nor participants were masked. Analysis was intention-to-treat. Results: We enrolled neighbors of WASH Benefits participants in 90 control (N=900) and 90 intervention clusters (N=899). Neighbors' characteristics were balanced across...Continue Reading

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Mentioned in this Paper

WASH6P
Trichocephalus
Randomized Controlled Trial (Publication)
Environment
Clinical Trials, Randomized
Health Outcomes
Hookworms
Coliform bacteria
Ancylostomatoidea
Participant

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