학술논문
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.
Document Type
Article
Author
George, Christine Marie; Monira, Shirajum; Zohura, Fatema; Thomas, Elizabeth D; Hasan, M Tasdik; Parvin, Tahmina; Hasan, Khaled; Rashid, Mahamud-ur; Papri, Nowshin; Islam, Aminul; Rahman, Zillur; Rafique, Raisa; Bhuyian, Md Sazzadul Islam; Saxton, Ronald; Labrique, Alain; Alland, Kelsey; Barman, Indrajeet; Jubyda, Fatema Tuz; Afroze, Farzana; Sultana, Marzia
Source
Subject
*DIARRHEA prevention
*PATIENT aftercare
*CELL phones
*FLUID therapy
*DIARRHEA
*CONFIDENCE intervals
*CHILD development
*HOME care services
*FAMILIES
*WATER supply
*TREATMENT effectiveness
*RANDOMIZED controlled trials
*COMMUNICATION
*HAND washing
*STATISTICAL sampling
*TELEMEDICINE
*GROWTH disorders
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Language
ISSN
1058-4838
Abstract
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. [ABSTRACT FROM AUTHOR]