Acceptability and Effectiveness of Household Water Treatment in Reducing Diarrhea Among Under Five Children

Study Overview
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Brief Summary
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The Millenium development goals (MDGs) call for reducing by half the proportion of people without sustainable access to safe drinking water. This goal was adopted in large part because safe drinking water has been seen as critical to fighting diarrheal disease. Source protection is considered the main intervention area to achieve this goal. However, research worldwide that has shown that even drinking water which is safe at the source is subject to frequent and extensive fecal contamination during collection, storage and use in the home. This contamination is through the introduction of cups, dippers or hands, contamination by flies, cockroaches, and rats. Even piped water supplies of adequate microbial quality can pose infectious disease risks if they become contaminated due to unsanitary collection, storage conditions and practices within households. To reduce this problem, point-of-use water treatment has been advocated as a means to substantially decrease the global burden of diarrhea and to contribute to the MDGs. However, research indicates that there are many unanswered questions around Household water treatment (HWT) that require small or medium scale epidemiological studies and randomized controlled trials, especially with regard to effectiveness, acceptability and identifying suitable target populations. Some of the most urgent questions to be resolved are:(1) How much of the currently cited disease reduction of HWT is due to bias? (2) What is the effect of HWT on nutritional status (weight gain and growth)?(3) At which populations should HWT be targeted? (4) Is it acceptable and sustainable in poor communities where the risk of diarrheal disease is high. hypothesis: Do household water treatment with chlorine reduce diarrhea among underfive children? hypothesis: Do household water treatment with chlorine acceptable in the community?

Official Title
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Acceptability and Effectiveness of Household Water Chlorination in Reducing the Prevalence of Diarrhea Among Under Five Children in Eastern Ethiopia

Conditions
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Acute Diarrhoea

Intervention / Treatment
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* Other: household water treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All children under five years of age in the randomly selected clusters of Kersa district Exclusion Criteria: seriously sick children in the randomly selected clusters of Kersa district

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 59 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Household water treatment<br>household water treatment with 1.25% sodium hypochlorite | Other: household water treatment<br>* household water treatment with 1.25% sodium hypochlorite<br>* Other names: 1.25% sodium hypochlorite;|
| No Intervention: control<br>Usual practice (the use of Jerrican for water storage, which is considered as safe storage) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To assess the prevalence of diarrhea among under five children | weekly visit of the household for the presence of diarrhoea among underfive for four months in both the intervention and control groups | four months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To assess the weight gain among the intervention and control groups of under five children | This is designed to assess whether there is weight gain (objective outcome) in children assigned to the intervention group compared to the control group. It is supplement to the prevalence of diarrhea which is subjective outcome for this study | At the beginning and end of the study ( 4 months interval) | 
| Residual chlorine test | The use of the intervention (1.25% hypochlorite) is confirmed by the testing the residual chlorine weekly for for months from each household assigned in the intrevention group | four months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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three or more loss stools in 24 hours