Reducing diarrhoea in school children and control of the dengue vector Aedes aegypti in rural primary schools in Colombia by targeted disease-specific interventions: a factorial cluster randomized controlled trial

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  • Publisher: isrctn

Background and study aims Diarrhea and dengue fever are major diseases which, between them, kill millions of people around the world each year. Water is important for both diseases. Dirty drinking and cooking water is a common cause of diarrhea, and dengue is spread by mosquitoes which can breed in water containers. In this study we want to see whether improving water hygiene and storage can reduce the two diseases in schoolchildren. We are doing the study in schools for three main reasons. First, dengue mosquitoes tend to bite a lot in the mornings when children are likely to be in school. Also, not all schools in the study area have hygienic drinking water, so children may catch diarrhea-causing organisms there. Finally, we want to teach children something about how people catch these diseases which will hopefully encourage preventive measures at home. Who can participate? We are doing the study in rural primary schools in the municipalities of La Mesa and Anapoima, Cundinamarca department. The school principal has to agree before the school can take part and we won’t we include large schools (if they have more than 100 pupils and more than five grades) or those which are inaccessible or closed, or those which are involved in any other programme to control diarrhea or dengue. We will record diarrhea and dengue illness in all pupils in grades 1-5 in all selected rural schools. It doesn’t matter what age the children are, or whether they are boys or girls, or whether or not they have had diarrhea or dengue or any other illness in the past, but we will only record a child’s illness if they agree and if one of their parents also agrees. New children that enter these schools in the middle of the study can also join the study in the same way. What does the study involve? We will implement interventions that aim to reduce diarrhea and other interventions that aim to reduce dengue. The participating schools will be randomly allocated to receive either the diarrhea interventions, the dengue interventions, both interventions, or neither of the interventions. The reason for not doing anything in some schools is so that we can tell whether any changes in disease are due to the interventions or to other things which affect all schools, such as having a lot of rain one year. For diarrhea, we will: 1. Provide drinking water filters 2. Promote hand washing with soap 3. Put lids on as many water storage containers as we can 4. Clean the drinking water storage containers once or twice a term 5. Promote cleaning toilets every day 6. Teach children about diarrhea, water and hygiene For dengue, we will: 1. Fit windows with curtains made out of nets treated with insecticide 2. Put lids on as many water storage containers as we can 3. Put a different insecticide in any water containers that we can’t cover properly with a lid 4. Encourage the schools to tidy up rubbish, especially old containers which can get wet inside 5. Teach children about dengue and about mosquitoes and where they breed We will measure how well the interventions are working by recording the incidence of diarrhea and dengue in children, and by seeing how many dengue mosquitoes there are in each school. What are the possible benefits and risks of participating? In some schools in the study, we will try to make the water cleaner, to reduce the number of mosquitoes, and to teach children about diarrhea and dengue. We hope that these actions will reduce the incidence of diarrhea and dengue in children. In some schools we are going to use net curtains treated with insecticide. This kind of netting has been approved by the World Health Organization to be used this way. However, if held next to the skin, it may produce tingling and similar feelings. Some water containers that we can’t cover properly will instead be treated with a different insecticide to stop the mosquitoes hatching out properly. Only non-drinking water containers will be given this insecticide. When used this way there are no known risks to people, and it has been approved by the World Health Organization. Where is the study run from? We are asking children and teachers in rural primary schools in the municipalities of La Mesa and Anapoima (Cundinamarca department) to participate. The study will be run from Universidad El Bosque in Bogotá. When is the study starting and how long is it expected to run for? We expect the study to start in February 2012 and run until November 2013. Who is funding the study? The study is mostly funded by the Research Council of Norway. Also, the Lazos de Calandaima Foundation will pay some of the workers who live in the study area. Who is the main contact? Dr María Inés Matiz
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