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Improving household air, drinking water and hygiene in rural Peru: a community-randomized-controlled trial of an integrated environmental home-based intervention package to improve child health

Hartinger, SM ; Lanata, CF ; Hattendorf, J. ; Verastegui, H. ; Gil, AI ; Wolf, J. ; Mäusezahl, D.

In: International Journal of Epidemiology, 2016, vol. 45, no. 6, p. 2089-2099

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    Titel
    • Improving household air, drinking water and hygiene in rural Peru: a community-randomized-controlled trial of an integrated environmental home-based intervention package to improve child health
    Autor
    • Hartinger, SM. Swiss Tropical and Public Health Institute, Basel, Switzerland
    • Lanata, CF. Instituto de Investigación Nutricional, Lima, Peru
    • Hattendorf, J.. Swiss Tropical and Public Health Institute, Basel, Switzerland
    • Verastegui, H.. Instituto de Investigación Nutricional, Lima, Peru
    • Gil, AI. Instituto de Investigación Nutricional, Lima, Peru
    • Wolf, J.. Swiss Tropical and Public Health Institute, Basel, Switzerland
    • Mäusezahl, D.. Swiss Tropical and Public Health Institute, Basel, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • International Journal of Epidemiology, 2016, vol. 45, no. 6, p. 2089-2099. Oxford University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:331590
    Summary
    Background: Diarrhoea and acute lower respiratory infections are leading causes of childhood morbidity and mortality, which can be prevented by simple low-cost interventions. Integrated strategies can provide additional benefits by addressing multiple health burdens simultaneously. Methods: We conducted a community-randomized-controlled trial in 51 rural communities in Peru to evaluate whether an environmental home-based intervention package, consisting of improved solid-fuel stoves, kitchen sinks, solar disinfection of drinking water and hygiene promotion, reduces lower respiratory infections, diarrhoeal disease and improves growth in children younger than 36 months. The attention control group received an early child stimulation programme. Results: We recorded 24647 child-days of observation from 250 households in the intervention and 253 in the attention control group during 12-month follow-up. Mean diarrhoea incidence was 2.8 episodes per child-year in the intervention compared with 3.1 episodes in the control arm. This corresponds to a relative rate of 0.78 [95% confidence interval (CI): 0.58-1.05] for diarrhoea incidence and an odds ratio of 0.71 (95% CI: 0.47-1.06) for diarrhoea prevalence. No effects on acute lower respiratory infections or children's growth rates were observed. Conclusions: Combined home-based environmental interventions slightly reduced childhood diarrhoea, but the confidence interval included unity. Effects on growth and respiratory outcomes were not observed, despite high user compliance of the interventions. The absent effect on respiratory health might be due to insufficient household air quality improvements of the improved stoves and additional time needed to achieve attitudinal and behaviour change when providing composite interventions.