Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial
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Fecha
2012
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Trials, 1745-6215, Vol. 11, 2012, p.1-11
Publicado por
Biomed Central
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Abstract
Background: Diarrheal diseases and dengue fever are major global health problems. Where provision of clean
water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal
illness, but stored water also provides breeding sites for dengue vector mosquitoes. Poor household water
management and sanitation are therefore potential determinants of both diseases. Little is known of the role of
stored water for the combined risk of diarrhea and dengue, yet a joint role would be important for developing
integrated control and management efforts. Even less is known of the effect of integrating control of these diseases
in school settings. The objective of this trial was to investigate whether interventions against diarrhea and dengue
will significantly reduce diarrheal disease and dengue entomological risk factors in rural primary schools.
Methods/design: This is a 2×2 factorial cluster randomized controlled trial. Eligible schools were rural primary
schools in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Eligible pupils were school children in
grades 0 to 5. Schools were randomized to one of four study arms: diarrhea interventions (DIA); dengue
interventions (DEN); combined diarrhea and dengue interventions (DIADEN); and control (C). Schools were allocated
publicly in each municipality (strata) at the start of the trial, obviating the need for allocation concealment. The
primary outcome for diarrhea is incidence rate of diarrhea in school children and for dengue it is density of adult
female Aedes aegypti per school. Approximately 800 pupils from 34 schools were enrolled in the trial with eight
schools in the DIA arm, nine in the DEN, eight in the DIADEN, and nine in the control arms. The trial status as of
June 2012 was: completed baseline data collections; enrollment, randomization, and allocation of schools. The trial
was funded by the Research Council of Norway and the Lazos de Calandaima Foundation.
Discussion: This is the first trial investigating the effect of a set of integrated interventions to control both dengue
and diarrhea. This is also the first trial to study the combination of diarrhea-dengue disease control in school
settings.
Palabras clave
Keywords
Dengue, Diarrhea, Primary schools
Temáticas
Dengue -- Prevención y control
Instituciones académicas
Medio rural
Instituciones académicas
Medio rural