A Controlled, Before-And-After Trial Of An Urban Sanitation Intervention To Reduce Enteric Infections In Children: Research Protocol For The Maputo Sanitation (Mapsan) Study, Mozambique

ASU Author/Contributor (non-ASU co-authors, if there are any, appear on document)
Richard Rheingans Ph.D., Department Chair (Creator)
Institution
Appalachian State University (ASU )
Web Site: https://library.appstate.edu/

Abstract: Introduction:Access to safe sanitation in low-income, informal settlements of Sub-Saharan Africa has not significantly improved since 1990. The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment in expanding sanitation access in densely populated urban slums can yield important public health gains. No rigorous, controlled intervention studies have evaluated the health effects of decentralised (non-sewerage) sanitation in an informal urban setting, despite the role that such technologies will likely play in scaling up access.Methods and analysis: We have designed a controlled, before-and-after (CBA) trial to estimate the health impacts of an urban sanitation intervention in informal neighbourhoods of Maputo, Mozambique, including an assessment of whether exposures and health outcomes vary by localised population density. The intervention consists of private pour-flush latrines (to septic tank) shared by multiple households in compounds or household clusters. We will measure objective health outcomes in approximately 760 children (380 children with household access to interventions, 380 matched controls using existingshared private latrines in poor sanitary conditions), at 2 time points: immediately before the intervention and at follow-up after 12 months. The primary outcome is combined prevalence of selected enteric infections among children under 5 years of age. Secondary outcome measures include soil-transmitted helminth (STH) reinfection in children following baseline deworming and prevalence of reported diarrhoeal disease. We will use exposure assessment, faecal source tracking, and microbial transmission modelling to examine whether and how routesof exposure for diarrhoeagenic pathogens andSTHs change following introduction of effective sanitation.

Additional Information

Publication
Richard Rheingans, Joe Brown, Oliver Cumming, Jamie Bartram, Sandy Cairncross, Jeroen Ensink, David Holcomb, Jackie Knee, Peter Kolsky, Kaida Liang, Song Liang, Rassul Nala, Guy Norman, Jill Stewart, Olimpio Zavale, Valentina Zuin, Wolf-Peter Schmidt Schmidt (2015) "A Controlled, Before-And-After Trial Of An Urban Sanitation Intervention To Reduce Enteric Infections In Children: Research Protocol For The Maputo Sanitation (Mapsan) Study, Mozambique" BMJ Open 5(6) Version of Record Available From (0-bmjopen.bmj.com)
Language: English
Date: 2015
Keywords
urban sanitation, faecal-related diseases, Mozambiqe

Email this document to