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Combinando el tratamiento del agua potable y el lavado de manos para la prevención de la diarrea, un ensayo aleatorizado, controlado por clusters.
Author(s) -
Luby Stephen P.,
Agboatwalla Mubina,
Painter John,
Altaf Arshad,
Billhimer Ward,
Keswick Bruce,
Hoekstra Robert M.
Publication year - 2006
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2006.01592.x
Subject(s) - disinfectant , hand washing , medicine , hygiene , psychological intervention , environmental health , nursing , pathology
Summary Objectives To evaluate the effectiveness of point of use water treatment with flocculent‐disinfectant on reducing diarrhoea and the additional benefit of promoting hand washing with soap. Methods The study was conducted in squatter settlements of Karachi, Pakistan, where diarrhoea is a leading cause of childhood death. Interventions were randomly assigned to 47 neighbourhoods. Households in 10 neighbourhoods received diluted bleach and a water vessel; nine neighbourhoods received soap and were encouraged to wash hands; nine neighbourhoods received flocculent‐disinfectant water treatment and a water vessel; 10 neighbourhoods received disinfectant‐disinfectant water treatment and soap and were encouraged to wash hands; and nine neighbourhoods were followed as controls. Field workers visited households at least once a week from April to December 2003 to promote use of the interventions and to collect data on diarrhoea. Results Study participants in control neighbourhoods had diarrhoea on 5.2% of days. Compared to controls, participants living in intervention neighbourhoods had a lower prevalence of diarrhoea: 55% (95% CI 17%, 80%) lower in bleach and water vessel neighbourhoods, 51% (95% CI 12%, 76%) lower in hand washing promotion with soap neighbourhoods, 64% lower (95% CI 29%, 90%) in disinfectant‐disinfectant neighbourhoods, and 55% (95% CI 18%, 80%) lower in disinfectant‐disinfectant plus hand washing with soap neighbourhoods. Conclusions With an intense community‐based intervention and supplies provided free of cost, each of the home‐based interventions significantly reduced diarrhoea. There was no benefit by combining hand washing promotion with water treatment.