This library entry contains background documents for a grant that John M. Colford is leading and which is funded by the Bill and Melinda Gates Foundation. Further information is also available on the SuSanA discussion forum, see link below. Short description of the project: Enteric infections (e.g., diarrhea due to infectious causes) and growth faltering (also called stunting of children) are major burdens of disease among young children in low-income countries. Improvements in water, sanitation, and handwashing (WASH), together with improvements in nutrition, are thought to reduce these disease burdens. However, there have been few rigorous studies to measure the effects of WASH interventions on growth and the effects of combined interventions (e.g., WASH + Nutrition) compared with single interventions. The WASH Benefits study includes two highly comparable randomized trials in rural communities -- one in Bangladesh, one in Kenya -- that will measure the effect of providing improved household compound-level WASH and nutritional interventions, alone and in combination, to a large birth cohort of children. Methodology: WASH Benefits includes two cluster-randomised trials to assess improvements in water quality, sanitation, handwashing and child nutrition—alone and in combination—to rural households with pregnant women in Kenya and Bangladesh. Geographically matched clusters (groups of household compounds in Bangladesh and villages in Kenya) will be randomised to one of six intervention arms or control. Intervention arms include water quality, sanitation, handwashing, nutrition, combined water+sanitation+handwashing (WSH) and WSH+nutrition. Goal: To generate rigorous evidence about the impacts of water quality, sanitation, handwashing and nutritional interventions on child health and development in the first two years of life. Primary scientific objectives: - Measure the impact of sanitation, water quality, handwashing and nutrition interventions (see below for details) on child diarrhoea and linear growth after 2 years of exposure. - Determine whether there are larger reductions in child diarrhoea when providing a combined water, sanitation and handwashing intervention compared to each component alone. - Determine whether there are larger effects on child diarrhoea and linear growth from combining (A) a comprehensive child nutrition intervention with ( B ) a combined water, sanitation and handwashing intervention compared to A or B alone. Secondary scientific objectives: - Measure the impact of a child nutritional intervention and household environmental interventions on environmental enteropathy biomarkers (e.g., lactulose, mannitol, myeloperoxidase, alpha-1 antitrypsin, neopterin, total IgG), and more clearly elucidate this potential pathway between environmental interventions and child growth and development. - Measure the impact of sanitation, water quality, handwashing and nutritional interventions on intestinal parasitic infection prevalence and intensity by conducting Kato-Katz, PCR, and ELISA on stool samples. - Measure the association between parasitic infection and other measures of enteric health, including acute diarrhoea and environmental enteropathy biomarkers. +++++++++++ Documents available for download below: 1 - Arnold, B. F. et al. (2013): Cluster-randomised controlled trials of individual and combined water, sanitation, hygiene and nutritional interventions in rural Bangladesh and Kenya: the WASH Benefits study design and rationale. BMJ Open, 3:e003476

Bibliographic information

Various authors (2015). Measuring the benefits of water quality, sanitation, handwashing and nutritional interventions for improving health and child development (WASH Benefits) Various documents on results from research grant University of California - Berkeley (UCB)

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Fundamental research and engineeringEnglish

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BangladeshKenya

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