Evaluation of the Dubai Cares WASH in School Initiative

NCT01787058 | Completed

• 1 other identifier: IRB00060756
• Study Type: observational
• Target: 10,308
• Locations: 1 country
• Sites: 1

Brief Summary

This study will use longitudinal data collection to quantify the impact of a school-based water, sanitation and hygiene (WASH) program in Mali, West Africa, on pupil absenteeism, diarrheal illness, and respiratory illness. Data will be collected from 100 intervention and 100 control schools across 4 regions in Mali. At each school research staff will randomly select 60 pupils in grades 3-6 (typically ages 7-14). Research staff will ask school directors to provide written consent for pupil participation in place of parents, a procedure that has been approved by the Malian Ministry of Education. Research staff will approach selected pupils at school to request informed oral assent for participation. The informed assent process and data collection will be conducted by local trained enumerators in the child's preferred language of French or Bambara. Oral rather than written assent was chosen due to varied literacy capabilities and to limit paperwork that identifies participants. Data collection will take place at each school once every six to eight weeks during the duration of two school years. Research staff will conduct observations of school facilities, observations of handwashing behavior of children upon leaving latrines, and an interview with the school director about WASH conditions and school enrollment information. None of these school activities collect personal data or identifiers. Data collection with pupils will be done with the same pupils every 6-8 weeks and entails a 5-minute interview asking about recent absence and symptoms of diarrhea and respiratory illness. All data collection will occur at the school, will be conducted by trained local enumerators, and will be stored on password-protected mobile data collection devices. Data will be uploaded to a password-protected server and will not contain personal identifying information. Enumerators will maintain a separate form that links pupil IDs with names, which will be kept confidential. There are no direct benefits other than contribution to general knowledge that will inform future school WASH projects. There are no risks to participation other than a small amount of class time missed by pupils, and great efforts will be made to minimize time outside of class.

Conditions

Absenteeism; Diarrhea; Respiratory Tract Infections

Keywords

WASH; schoolchildren; absenteeism

Outcome Measures

Primary Outcomes (1)

• Absenteeism rate

  This indicator measures whether a pupil is absent on the day of a study staff visit. An all-school roll call will be used to measure single-day absenteeism for all pupils in grades 1-6. This indicator is collected longitudinally over the course of the trial with a time point every 6-8 weeks. Investigators will compare rates in intervention and control groups. This outcome is not a change outcome or a single outcome. It is a rate, which is a count of events over a specified period of time. This outcome measures more than one time point.

  Every 6-8 weeks. Partcipants will be followed for 16 months (February 2013-June 2014)

Secondary Outcomes (4)

• 7-day period prevalence of absenteeism

  Every 6-8 weeks. Participants will be followed for 16 months (February 2013-June 2014)

• 7-day period prevalence of respiratory infection

  Longitudinal prevalence: Baseline and every 6-8 weeks. Participants will be followed for 16 months (February 2013-June 2014)

• 2- and 7-day period prevalence of diarrhea

  Longitudinal prevalence: Baseline and every 6-8 weeks. Participants will be followed for 16 months (February 2013-June 2014)

• Prevalence of blood antibodies for enteric and neglected tropical diseases

  Once, between February and March 2014

Other Outcomes (3)

• Retention percentage

  Baseline and every 6-8 weeks. Participants will be followed for 16 months (February 2013-June 2014)

• Pass percentage

  3 months and 15 months (corresponding with end of school year June 2013 and June 2014)

• Progression percentage

  3 months and 15 months (corresponding with end of school year June 2013 and June 2014)

Study Arms (2)

Dubai Cares beneficiary

Pupils who attend a school that has benefitted from a water, sanitation and hygiene intervention as part of the Dubai Cares program.

Other: Dubai Cares beneficiary

Control

Pupils who attend a school of the same size and location as a school that benefitted from a water, sanitation and hygiene (WASH) intervention through the Dubai Cares program, but which has not benefitted from that program or any other WASH program since 2009.

Interventions

Dubai Cares beneficiary OTHER

Installation or rehabilitation of school water points, latrines and hygiene kits; promotion of good WASH practices and behavior change at school and within the community; establishment of management systems to ensure sustained WASH financing, monitoring and maintenance.

Dubai Cares beneficiary

Eligibility Criteria

• Age: 6 Years - 14 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)
• Sampling Method: Probability Sample

Study Population

Primary school students attending public schools in the Koulikoro, Sikasso, Bamako, and Mopti regions of Mali

You may qualify if:

• Attendance in a school that was randomly sampled from either the list of schools participating in the Dubai Cares water, sanitation and hygiene program or a list of non-program schools of the same size and in the same geographic area as a program school.
• In 3-6 grades

You may not qualify if:

• Inability to understand basic questions asked in French or one of three common local languages

Sponsors & Collaborators

• Emory University: lead
• WaterAid: collaborator
• Dubai Cares: collaborator
• CARE: collaborator
• Save the Children: collaborator
• Oxfam: collaborator
• UNICEF: collaborator

Study Sites (1)

Bamako, Sikasso, Koulikoro, and Mopti Regions

Bamako, Mali

Location

Related Publications (3)

• Trinies V, Garn JV, Chang HH, Freeman MC. The Impact of a School-Based Water, Sanitation, and Hygiene Program on Absenteeism, Diarrhea, and Respiratory Infection: A Matched-Control Trial in Mali. Am J Trop Med Hyg. 2016 Jun 1;94(6):1418-25. doi: 10.4269/ajtmh.15-0757. Epub 2016 Apr 25.

  PMID: 27114292 RESULT

• Chard AN, Trinies V, Moss DM, Chang HH, Doumbia S, Lammie PJ, Freeman MC. The impact of school water, sanitation, and hygiene improvements on infectious disease using serum antibody detection. PLoS Negl Trop Dis. 2018 Apr 16;12(4):e0006418. doi: 10.1371/journal.pntd.0006418. eCollection 2018 Apr.

  PMID: 29659574 RESULT

• Rogier E, Moss DM, Chard AN, Trinies V, Doumbia S, Freeman MC, Lammie PJ. Evaluation of Immunoglobulin G Responses to Plasmodium falciparum and Plasmodium vivax in Malian School Children Using Multiplex Bead Assay. Am J Trop Med Hyg. 2017 Feb 8;96(2):312-318. doi: 10.4269/ajtmh.16-0476. Epub 2016 Nov 28.

  PMID: 27895279 DERIVED

MeSH Terms

Conditions

Diarrhea; Respiratory Tract Infections

Condition Hierarchy (Ancestors)

Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Infections; Respiratory Tract Diseases

Study Officials

• Matthew C Freeman, PhD

  Emory University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 1, 2013
• First Posted: February 8, 2013
• Study Start: January 1, 2013
• Primary Completion: June 1, 2014
• Study Completion: June 1, 2014
• Last Updated: May 6, 2019

Record last verified: 2019-05

Locations

MA (1)