Study design of a cluster-randomized controlled trial to evaluate a large-scale distribution of cook stoves and water filters in Western Province, Rwanda
| Autor: | Miles A. Kirby, Corey L. Nagel, Laura D. Zambrano, Thomas Clasen, Ghislane Rosa, Evan A. Thomas, Christina Barstow |
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| Rok vydání: | 2016 |
| Předmět: |
Diarrhea
IMCI Integrated Management of Childhood Illness Psychological intervention Developing country MOH Rwanda Ministry of Health 010501 environmental sciences DBSS dried blood spot samples Disease cluster ICCM Integrated Community Case Management of Childhood Illness 01 natural sciences Article Cluster randomized controlled trial law.invention 03 medical and health sciences H-PEM Harvard Personal Exposure Monitor Improved stoves 0302 clinical medicine Randomized controlled trial Environmental protection law Environmental health CHW community health worker Medicine MFI mean fluorescence intensity 030212 general & internal medicine RCT randomized controlled trial 0105 earth and related environmental sciences Pharmacology lcsh:R5-920 Under-five business.industry Rwanda Respiratory infection General Medicine ARI acute respiratory infection HAP household air pollution Acute respiratory infection Stove Scale (social sciences) MOLG Rwandan Ministry of Local Government lcsh:Medicine (General) Household water treatment business |
| Zdroj: | Contemporary Clinical Trials Communications Contemporary Clinical Trials Communications, Vol 4, Iss C, Pp 124-135 (2016) |
| ISSN: | 2451-8654 |
| Popis: | Background In Rwanda, pneumonia and diarrhea are the first and second leading causes of death, respectively, among children under five. Household air pollution (HAP) resultant from cooking indoors with biomass fuels on traditional stoves is a significant risk factor for pneumonia, while consumption of contaminated drinking water is a primary cause of diarrheal disease. To date, there have been no large-scale effectiveness trials of programmatic efforts to provide either improved cookstoves or household water filters at scale in a low-income country. In this paper we describe the design of a cluster-randomized trial to evaluate the impact of a national-level program to distribute and promote the use of improved cookstoves and advanced water filters to the poorest quarter of households in Rwanda. Methods/Design We randomly allocated 72 sectors (administratively defined units) in Western Province to the intervention, with the remaining 24 sectors in the province serving as controls. In the intervention sectors, roughly 100,000 households received improved cookstoves and household water filters through a government-sponsored program targeting the poorest quarter of households nationally. The primary outcome measures are the incidence of acute respiratory infection (ARI) and diarrhea among children under five years of age. Over a one-year surveillance period, all cases of acute respiratory infection (ARI) and diarrhea identified by health workers in the study area will be extracted from records maintained at health facilities and by community health workers (CHW). In addition, we are conducting intensive, longitudinal data collection among a random sample of households in the study area for in-depth assessment of coverage, use, environmental exposures, and additional health measures. Discussion Although previous research has examined the impact of providing household water treatment and improved cookstoves on child health, there have been no studies of national-level programs to deliver these interventions at scale in a developing country. The results of this study, the first RCT of a large-scale programmatic cookstove or household water filter intervention, will inform global efforts to reduce childhood morbidity and mortality from diarrheal disease and pneumonia. Trial registration This trial is registered at Clinicaltrials.gov (NCT02239250). |
| Databáze: | OpenAIRE |
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