Effects of a Water, Sanitation, and Hygiene Mobile Health Program on Diarrhea and Child Growth in Bangladesh: A Cluster-randomized Controlled Trial of the Cholera Hospital-based Intervention for 7 Days (CHoBI7) Mobile Health Program.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
02 11 2021
Historique:
received: 12 03 2020
accepted: 27 07 2020
pubmed: 8 8 2020
medline: 11 11 2021
entrez: 8 8 2020
Statut: ppublish

Résumé

The Cholera Hospital-Based Intervention for 7 Days (CHoBI7) mobile health (mHealth) program was a cluster-randomized controlled trial of diarrhea patient households conducted in Dhaka, Bangladesh. Patients were block-randomized to 3 arms: standard message on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (no home visits); and health facility delivery of CHoBI7 plus 2 home visits and mHealth. The primary outcome was reported diarrhea in the past 2 weeks collected monthly for 12 months. The secondary outcomes were stunting, underweight, and wasting at a 12-month follow-up. Analysis was intention-to-treat. Between 4 December 2016 and 26 April 2018, 2626 participants in 769 households were randomly allocated to 3 arms: 849 participants to the standard message arm, 886 to mHealth with no home visits arm, and 891 to the mHealth with 2 home visits. Children <5 years had significantly lower 12-month diarrhea prevalence in both the mHealth with 2 home visits arm (prevalence ratio [PR]: 0.73 [95% confidence interval {CI}, .61-.87]) and the mHealth with no home visits arm (PR: 0.82 [95% CI, .69-.97]). Children <2 years were significantly less likely to be stunted in both the mHealth with 2 home visits arm (33% vs 45%; odds ratio [OR]: 0.55 [95% CI, .31-.97]) and the mHealth with no home visits arm (32% vs 45%; OR: 0.54 [95% CI, .31-.96]) compared with children in the standard message arm. The CHoBI7 mHealth program lowered pediatric diarrhea and stunting among diarrhea patient households. NCT04008134.

Sections du résumé

BACKGROUND
The Cholera Hospital-Based Intervention for 7 Days (CHoBI7) mobile health (mHealth) program was a cluster-randomized controlled trial of diarrhea patient households conducted in Dhaka, Bangladesh.
METHODS
Patients were block-randomized to 3 arms: standard message on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (no home visits); and health facility delivery of CHoBI7 plus 2 home visits and mHealth. The primary outcome was reported diarrhea in the past 2 weeks collected monthly for 12 months. The secondary outcomes were stunting, underweight, and wasting at a 12-month follow-up. Analysis was intention-to-treat.
RESULTS
Between 4 December 2016 and 26 April 2018, 2626 participants in 769 households were randomly allocated to 3 arms: 849 participants to the standard message arm, 886 to mHealth with no home visits arm, and 891 to the mHealth with 2 home visits. Children <5 years had significantly lower 12-month diarrhea prevalence in both the mHealth with 2 home visits arm (prevalence ratio [PR]: 0.73 [95% confidence interval {CI}, .61-.87]) and the mHealth with no home visits arm (PR: 0.82 [95% CI, .69-.97]). Children <2 years were significantly less likely to be stunted in both the mHealth with 2 home visits arm (33% vs 45%; odds ratio [OR]: 0.55 [95% CI, .31-.97]) and the mHealth with no home visits arm (32% vs 45%; OR: 0.54 [95% CI, .31-.96]) compared with children in the standard message arm.
CONCLUSIONS
The CHoBI7 mHealth program lowered pediatric diarrhea and stunting among diarrhea patient households.
CLINICAL TRIALS REGISTRATION
NCT04008134.

Identifiants

pubmed: 32761174
pii: 5881860
doi: 10.1093/cid/ciaa754
pmc: PMC8563223
doi:

Substances chimiques

Water 059QF0KO0R

Banques de données

ClinicalTrials.gov
['NCT04008134']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e2560-e2568

Subventions

Organisme : United States Agency for International Development

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

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Auteurs

Christine Marie George (CM)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Shirajum Monira (S)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Fatema Zohura (F)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Elizabeth D Thomas (ED)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

M Tasdik Hasan (MT)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Tahmina Parvin (T)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Khaled Hasan (K)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Mahamud-Ur Rashid (MU)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Nowshin Papri (N)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Aminul Islam (A)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Zillur Rahman (Z)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Raisa Rafique (R)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Md Sazzadul Islam Bhuyian (MS)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Ronald Saxton (R)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Alain Labrique (A)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Kelsey Alland (K)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Indrajeet Barman (I)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Fatema Tuz Jubyda (FT)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Farzana Afroze (F)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Marzia Sultana (M)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Fatema-Tuz Johura (FT)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

Md Abul Hasem Khan (MAH)

Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh.

Sanya Tahmina (S)

Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh.

Farzana Munmun (F)

Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh.

David A Sack (DA)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Jamie Perin (J)

Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Munirul Alam (M)

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.

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Classifications MeSH