Comparing the effect of independent and combined interventions of household chlorination and handwashing on diarrhea of under-fives in rural Dire Dawa, Eastern Ethiopia: a cluster randomized controlled trial.

in poorly developed countries, no single intervention is adequate to interrupt diarrhea occurrence in rural households. However, the effect sizes of multiple interventions and participants combined adherence to the interventions are understudied. This study aimed at comparing combined intervention of water sanitation and hygiene (WASH) with each individual intervention in reducing diarrhea among under-five children in rural Dire Dawa. a cluster randomized controlled factorial trial was conducted between October 2018 and January 2019. Householders in the first, second and third arms received waterguard, soap and both, respectively. However, householders in the control arm were followed with their customary practices. Generalized estimation equations (GEE) with log link Poisson distribution was used to compute adjusted incidence rate ratio and the corresponding 95% CIs. overall, 36% (aIRR = 0.64, 95% CI: 0.57 - 0.73), 41% (aIRR = 0.588, 95% CI: 0.53 - 0.65), and 41% (aIRR = 0.585, 95% CI: 0.53 - 0.65) reduction in incidence of diarrhea was observed in the water treatment, handwashing and combined arms, respectively. This study showed no additional benefit of combining the two interventions than the individual intervention. we recommend implementing either household water disinfection using sodium hypochlorite or household handwashing with hand hygiene promotion independently at large scale to vulnerable population to reduce diarrheal morbidity.

Solomon ET ，Gari SR ，Kloos H ，Alemu BM ... -  《-》

Effect of household water treatment with chlorine on diarrhea among children under the age of five years in rural areas of Dire Dawa, eastern Ethiopia: a cluster randomized controlled trial.

Solomon ET ，Robele S ，Kloos H ，Mengistie B ... -  《-》

Handwashing effect on diarrheal incidence in children under 5 years old in rural eastern Ethiopia: a cluster randomized controlled trial.

Solomon ET ，Gari SR ，Kloos H ，Alemu BM ... -  《-》

Household water chlorination reduces incidence of diarrhea among under-five children in rural Ethiopia: a cluster randomized controlled trial.

Mengistie B ，Berhane Y ，Worku A 《PLoS One》

The effect of SODIS water treatment intervention at the household level in reducing diarrheal incidence among children under 5 years of age: a cluster randomized controlled trial in Dabat district, northwest Ethiopia.

Bitew BD ，Gete YK ，Biks GA ，Adafrie TT ... -  《Trials》