Details:

Alternative Title:
Arch Pediatr Adolesc Med
Personal Author:
Bowen, Anna ; Agboatwalla, Mubina ; Luby, Stephen ; Tobery, Timothy ; Ayers, Tracy ; ... More +
Bowen, Anna ; Agboatwalla, Mubina ; Luby, Stephen ; Tobery, Timothy ; Ayers, Tracy ; Hoekstra, R. M. Less -
Description:
Objective

To evaluate associations between handwashing promotion and child growth and development.

Design

Cluster randomized controlled trial.

Setting

Informal settlements in Karachi, Pakistan.

Participants

A total of 461 children who were enrolled in a trial of household-level handwashing promotion in 2003 and were younger than 8 years at reassessment in 2009.

Interventions

In 2003, neighborhoods were randomized to control (n=9), handwashing promotion (n=9), or handwashing promotion and drinking water treatment (n=10); intervention households received free soap and weekly handwashing promotion for 9 months.

Main Outcome Measures

Anthropometrics and developmental quotients measured with the Battelle Developmental Inventory II at 5 to 7 years of age.

Results

Overall, 24.9% (95% CI, 20.0%–30.6%) and 22.1% (95% CI, 18.0%–26.8%) of children had z scores that were more than 2 SDs below the expected z scores for height and body mass index for age, respectively; anthropometrics did not differ significantly across study groups. Global developmental quotients averaged 104.4 (95% CI, 101.9–107.0) among intervention children and 98.3 (95% CI, 93.1–103.4) among control children (P=.04). Differences of similar magnitude were measured across adaptive, personal-social, communication, cognitive, and motor domains.

Conclusions

Although growth was similar across groups, children randomized to the handwashing promotion during their first 30 months of age attained global developmental quotients 0.4 SDs greater than those of control children at 5 to 7 years of age. These gains are comparable to those of at-risk children enrolled in publicly funded preschools in the United States and suggest that handwashing promotion could improve child wellbeing and societal productivity.

Trial Registration

clinicaltrials.gov Identifier: NCT01538953


Subjects:
[+]
Article Body Height Body Weight Child Child, Preschool Child Development Drinking Water Female Follow-Up Studies Hand Disinfection Health Promotion Humans Infant Infant, Newborn Male Psychological Tests Water Purification
Source:
Arch Pediatr Adolesc Med. 166(11):1037-1044.
Pubmed ID:
22986783
Pubmed Central ID:
PMC4648282
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
Pakistan
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:4b05199daa1e5404b09cbfd7c7d048317b765a4689627f3a017222fa23bf8957
Download URL:
https://stacks.cdc.gov/view/cdc/36660/cdc_36660_DS1.pdf
File Type:

Supporting Files

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