A controlled trial of bismuth subsalicylate in infants with acute watery diarrheal disease

We estimated the costs and benefits of a community-led total sanitation (CLTS) intervention using the empirical results from a cluster-randomized controlled trial in rural Ethiopia. We modelled benefits and costs of the intervention over 10 years, as compared to an existing local government program. Health benefits were estimated as the value of averted mortality due to diarrheal disease and the cost of illness arising from averted diarrheal morbidity. We also estimated the value of time savings from avoided open defecation and use of neighbours’ latrines. Intervention delivery costs were estimated top-down based on financial records, while recurrent costs were estimated bottom-up from trial data. We explored methodological and parameter uncertainty using one-way and probabilistic sensitivity analyses. Avoided mortality accounted for 58% of total benefits, followed by time savings from increased access to household latrines. The base case benefit–cost ratio was 3.7 (95% CI: 1.9–5.4) and the net present value was Int’l $1,193,786 (95% CI: 406,017–1,977,960). The sources of the largest uncertainty in one-way sensitivity analyses were the effect of the CLTS intervention and the assumed lifespan of an improved latrine. Our results suggest that CLTS interventions can yield favourable economic returns, particularly if follow-up after the triggering is implemented intensively and uptake of improved latrines is achieved (as opposed to unimproved).

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Local Drinking Water Filters Reduce Diarrheal Disease in Cambodia: A Randomized, Controlled Trial of the Ceramic Water Purifier

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.2008.79.394 ◽

2008 ◽

Vol 79 (3) ◽

pp. 394-400 ◽

Cited By ~ 64

Author(s):

Joe Brown ◽

Dana Loomis ◽

Mark D. Sobsey

Keyword(s):

Randomized Controlled Trial ◽

Drinking Water ◽

Diarrheal Disease ◽

Controlled Trial ◽

Randomized Controlled ◽

Water Filters

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Protocol for a cluster randomised trial to evaluate a community level complementary food safety and hygiene and nutrition intervention in Mali: The MaaCiwara study

10.1101/2021.12.15.21267512 ◽

2021 ◽

Author(s):

Samuel I Watson ◽

Evans A Asamane ◽

Richard J Lilford ◽

Karla Hemming ◽

Cheick Sidibe ◽

...

Keyword(s):

Food Safety ◽

Structural Equation ◽

Diarrheal Disease ◽

Controlled Trial ◽

Randomised Trial ◽

Complementary Food ◽

Cluster Randomised Trial ◽

Enteric Infection ◽

Community Based ◽

Cluster Randomised

Background Diarrheal disease remains a significant cause of morbidity and mortality among the under-fives in many low- and middle-income countries. Changes to food safety practices and feeding methods around the weaning period, alongside improved nutrition, may significantly reduce the risk of disease and improve development for infants. This article describes a protocol for a cluster randomized trial to evaluate the effectiveness of a multi-faceted community-based educational intervention that aims to improve food safety and hygiene behaviours and enhance child nutrition. Methods We will conduct a mixed-methods, parallel cluster randomised controlled trial with baseline measures. 120 clusters comprising small urban and rural communities will be recruited in equal numbers and randomly allocated in a 1:1 ratio to either treatment or control arms. Participants will be mother-child dyads (27 per cluster period) with children aged 6 to 24 months. Data collection will comprise a day of observation and interviews with each participating mother-child pair and will take place at baseline and four and 15 months post-intervention. The primary analysis will estimate the effectiveness of the intervention on changes to complementary food safety and preparation behaviours, food and water contamination, and diarrhoea. Secondary outcomes include maternal autonomy, enteric infection, nutritional content of meals, and child anthropometry. A secondary structural equation analysis will be conducted to examine the causal relationships between the different outcomes. Conclusions The trial will provide evidence on the effectiveness of community-based behavioural change and educational interventions designed to reduce the burden of diarrhoeal disease in the under fives, and how effectiveness varies across different contexts.

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Faculty of 1000 evaluation for A randomized controlled trial of the plastic-housing BioSand filter and its impact on diarrheal disease in Copan, Honduras.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.718172916.793486903 ◽

2013 ◽

Author(s):

David Alpers

Keyword(s):

Randomized Controlled Trial ◽

Diarrheal Disease ◽

Controlled Trial ◽

Randomized Controlled ◽

Biosand Filter ◽

Plastic Housing

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Injectable Amoxicillin Versus Injectable Ampicillin Plus Gentamicin in the Treatment of Severe Pneumonia in Children Aged 2 to 59 Months: Protocol for an Open-Label Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/17735 ◽

2020 ◽

Vol 9 (11) ◽

pp. e17735

Author(s):

Lubaba Shahrin ◽

Mohammod Jobayer Chisti ◽

Abu Sadat Mohammad Sayeem Bin Shahid ◽

Abu Sayem Mirza Mohammad Hasibur Rahman ◽

Md. Zahidul Islam ◽

...

Keyword(s):

Hospital Stay ◽

Diarrheal Disease ◽

Controlled Trial ◽

Severe Pneumonia ◽

World Health ◽

Open Label ◽

Once Daily ◽

Danger Signs ◽

Randomized Controlled ◽

Daily Dose

Background Pneumonia causes about 0.9 million deaths worldwide each year. The World Health Organization (WHO) guidelines for the standard management of severe pneumonia requires parenteral ampicillin every 6 hours and once-daily parenteral gentamicin for 5 to 7 days. Although this treatment has contributed to the reduction of mortality, it requires nursing interventions every 6 hours for 7 days. Further intervention trials should be conducted to search for alternate antibiotics with better adherence, reduced cost, and reduced hospital stay. Parenteral amoxicillin is an effective alternative to ampicillin, as it has a longer half-life and broader coverage. Objective The aim of this clinical trial is to compare the efficacy of a dose of injectable amoxicillin every 12 hours plus a once-daily dose of injectable gentamicin with a dose of injectable ampicillin every 6 hours plus a once-daily dose of injectable gentamicin in children hospitalized for severe pneumonia. Methods This randomized, controlled, open-label, noninferiority trial is being conducted in Dhaka Hospital of the International Centre for Diarrheal Disease Research, Bangladesh. A sample size of 308 children with severe pneumonia will give adequate power to this study. Children aged 2 to 59 months are randomized to either intravenous ampicillin or intravenous amoxicillin, plus intravenous gentamicin in both study arms. The monitoring of the patients is carried out according to the WHO protocol for the treatment of severe pneumonia. The primary objective is the rate of treatment failure, defined by the persistence of danger signs of severe pneumonia beyond 48 hours or deterioration within 24 hours of initiation of the therapy. The secondary objectives are (1) improvement in or the resolution of danger signs since enrollment, (2) length of hospital stay, (3) death during hospitalization, and (4) rate of nosocomial infections. Results Enrollment in the study started on January 1, 2018, and ended on October 31, 2019. Data entry and analysis are in progress. Findings from the study are expected to be disseminated in October 2020. Conclusions Our study's findings will improve compliance with the use of antibiotics that require less frequent doses for the treatment of severe pneumonia. Trial Registration ClinicalTrials.gov NCT03369093; https://clinicaltrials.gov/ct2/show/NCT03369093 International Registered Report Identifier (IRRID) DERR1-10.2196/17735

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