Benefits of a Household WASH Package to Community-based Management of Acute Malnutrition (CMAM) Program, Chad
NCT ID: NCT02486523
Last Updated: 2016-09-07
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
1572 participants
INTERVENTIONAL
2015-04-30
2016-05-31
Brief Summary
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Study design: cluster-randomized controlled trial comparing two interventions:
1. Control group: outpatient management of children diagnosed for severe acute malnutrition only
2. Intervention group: outpatient management of children diagnosed for severe acute malnutrition + "household WASH package"
2000 children, aged between 6 and 59 months, admitted to 20 OTP (Outpatient Therapeutic Program) centers for SAM will be included into the study and followed for 8 months (2 months of treatment, and 6 months after successful discharge).
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Detailed Description
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Clear evidence exists that some Water, Sanitation and Hygiene (WASH) interventions can successfully prevent diarrhea. For instance, interventions aiming at improving water quality at household level or at promoting hand washing with soap do reduce significantly diarrhea incidence. Estimations showed that WASH interventions have a small but measurable benefit on length growth, but not on weight or weight/height. Yet, to our knowledge, no impact of WASH interventions has been assessed, neither during nutritional rehabilitation where children are particularly vulnerable to infections, nor after discharge where immune recovery is still incomplete.
In the context of nutritional rehabilitation of SAM (Severe Acute Malnutrition), the investigators hypothesize that improving water quality and hygiene-related care practices at household level would decrease incidence of WASH-related infections, such as diarrhea, nematode and environmental enteropathy. As such, it would improve weight gain, decrease relapses after successful discharge, and overall, could decrease over time the incidence of acute malnutrition in the community.
The proposed WASH intervention will be added to already existing nutritional activities and it will include: i/ Household water treatment and hygiene kit (water container, water disinfection consumables, soap, cup, hygiene promotion leaflet) provided at beginning of SAM treatment; ii/ sessions of Hygiene promotion provided weekly at health center level iii/ Household visits and hygiene sessions made during the treatment; // group discussion on hygiene and care practices made with mother at community level after successful discharge.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Control group
Outpatient management of children diagnosed with severe acute malnutrition.
Interventions allocated:
Behavioral: Group discussions after successful discharge Procedure/Surgery: Outpatient Therapeutic Programme
Group discussions after successful discharge
Group discussions on hygiene and care practices with mothers at the community level after successful discharge.
Outpatient Therapeutic Programme
Home-based treatment and rehabilitation using Ready-to-use Therapeutic Food (RUTF) for children with severe acute malnutrition
Intervention group
Outpatient management of children diagnosed with severe acute malnutrition + "household WASH package"
Interventions allocated:
Behavioral: Hygiene promotion sessions Device: Household WASH package The content of the kit: soap and aquatab for 3 months, 20 liters Jerry can, a cup, a plastic kettle for hand washing and the instructions leaflet.
Behavioral: Household visits during the OTP phase Behavioral: Group discussions after successful discharge Procedure/Surgery: Outpatient Therapeutic Programme
Hygiene promotion sessions
Hygiene promotion sessions are provided weekly to the caretakers at the health center level. They contain 7 main messages this study is trying to get across: Allocate a protected space for children to play, limiting the likelihood of them ingesting soil or animal feces; Wash the child with soap (hand, face) when outside the protected area; Cleaning and rapid burial of children's stools; Key times for hand washing with soap for the child caretaker; Store drinking water in a closed container located in an elevated place out of reach of animals; Drinking water provided to the child should be treated with chlorine or boiled; Once weaned, avoid giving to the child leftover food, or only after warming it again.
Household WASH package
The content of the kit: 200 g soap, aquatab 67 g, 20 liters Jerry can, a cup, a plastic kettle for hand washing and the instructions leaflet.
Household visit
A household visit conducted by village's community health volunteers and ACF intervention staff during and after the treatment, to provide refresh training on the messages and the use of the kit.
Group discussions after successful discharge
Group discussions on hygiene and care practices with mothers at the community level after successful discharge.
Outpatient Therapeutic Programme
Home-based treatment and rehabilitation using Ready-to-use Therapeutic Food (RUTF) for children with severe acute malnutrition
Interventions
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Hygiene promotion sessions
Hygiene promotion sessions are provided weekly to the caretakers at the health center level. They contain 7 main messages this study is trying to get across: Allocate a protected space for children to play, limiting the likelihood of them ingesting soil or animal feces; Wash the child with soap (hand, face) when outside the protected area; Cleaning and rapid burial of children's stools; Key times for hand washing with soap for the child caretaker; Store drinking water in a closed container located in an elevated place out of reach of animals; Drinking water provided to the child should be treated with chlorine or boiled; Once weaned, avoid giving to the child leftover food, or only after warming it again.
Household WASH package
The content of the kit: 200 g soap, aquatab 67 g, 20 liters Jerry can, a cup, a plastic kettle for hand washing and the instructions leaflet.
Household visit
A household visit conducted by village's community health volunteers and ACF intervention staff during and after the treatment, to provide refresh training on the messages and the use of the kit.
Group discussions after successful discharge
Group discussions on hygiene and care practices with mothers at the community level after successful discharge.
Outpatient Therapeutic Programme
Home-based treatment and rehabilitation using Ready-to-use Therapeutic Food (RUTF) for children with severe acute malnutrition
Eligibility Criteria
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Inclusion Criteria
* New admission:
* Weight for Height Z-score (WHZ) \< -3 (WHO2006) or
* MUAC \<115 mm or
* Presence of bilateral oedema (+ or ++ at OTP admission)
* Other admission:
* Relapse: after a successful discharge or ≥ 2 months since last visit
* Re-admission: defaulter \< 2 months since last visit
* Transfer from a stabilization center (SC)
* Caretakers' agreement to participate (through an informed consent)
Exclusion Criteria
* Bilateral oedema (+++),
* Transfer from another OTP: treatment already started and child has a identification number (ID) for SAM
* Refusal of caretaker to participate
* Children from families outside the health center coverage
6 Months
59 Months
ALL
No
Sponsors
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Institute of Tropical Medicine, Belgium
OTHER
Association Sahélienne de Recherches Appliquées pour le Développement Durable
OTHER
Action Contre la Faim
OTHER
Responsible Party
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Mathias Altmann
Dr
Principal Investigators
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Mathias Altmann, Dr
Role: PRINCIPAL_INVESTIGATOR
ACTION CONTRE LA FAIM | ACF-France
Locations
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Health centers
Mao, Kanem Region, Chad
Countries
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Other Identifiers
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DFI.1836-554994
Identifier Type: -
Identifier Source: org_study_id
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