Diarrheal Disease Awareness Is Associated with Caregiver Handwashing with Soap in the Democratic Republic of the Congo (REDUCE Program)

Bisimwa, Lucien; Endres, Kelly; Williams, Camille; Thomas, Elizabeth; Kuhl, Jennifer; Coglianese, Nicole; Bauler, Sarah; Masud, Jahed; François, Ruthly; Saxton, Ronald; Sanvura, Presence; Bisimwa, Jean Claude; Mirindi, Patrick; Mwishingo, Alain; Perin, Jamie; George, Christine Marie

doi:10.4269/ajtmh.21-0699

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…Similar to our study, in Nigeria, many mothers thought diarrhea was caused by spirits [28]. In our REDUCE cohort study in rural eastern DRC, we found that caregiver diarrheal disease awareness was associated with caregiver handwashing with soap assessed by structured observation [29]. In addition, in our RCT of the CHoBI7 program for cholera patient households in Bangladesh, cholera awareness was a significant mediator of sustained handwashing with soap (assessed by structured observation) at the 6-to 12-month follow-up [30].…”

Section: Discussionsupporting

confidence: 86%

Formative Research for the Development of Evidence-Based Targeted Water, Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo: Preventative Intervention for Cholera for 7 Days (PICHA7) Program

Bisimwa

Williams

Bisimwa

et al. 2022

IJERPH

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Compared to the general public, household members of cholera patients are at a 100 times higher risk of contracting cholera during the 7-day high-risk period after a cholera patient has been admitted to a health facility for treatment. The Preventative-Intervention-for-Cholera-for-7-days (PICHA7) program aims to reduce household transmission of cholera during this 7-day high-risk period through a health facility-initiated water, sanitation, and hygiene (WASH) program promoting handwashing with soap, water treatment, and safe water storage. The PICHA7 program is delivered to cholera patient households through: (1) a pictorial flipbook delivered by a health promoter; (2) a cholera prevention package (handwashing station, drinking water vessel with lid and tap, and chlorine tablets); and (3) weekly WASH mobile messages sent to patient households in the Democratic Republic of the Congo (DRC). The objectives of this study were to conduct formative research to identify facilitators and barriers of the promoted WASH behaviors for cholera patient households and to tailor the PICHA7 program to target these facilitators and barriers. Formative research included 93 semi-structured interviews with diarrhea patient households and healthcare workers during exploratory research and a pilot study of 518 participants. Barriers to the promoted WASH behaviors identified during exploratory and pilot study interviews included: (1) low awareness of cholera transmission and prevention; (2) unaffordability of soap for handwashing; and (3) intermittent access to water limiting water for handwashing. For intervention development, narratives of the lived experiences of patient households in our study were presented by health promoters to describe cholera transmission and prevention, and soapy water and ash were promoted in the program flipbook and mobile messages to address the affordability of soap for handwashing. A jerry can was provided to allow for additional water storage, and a tap with a slower flow rate was attached to the handwashing station to reduce the amount of water required for handwashing. The pilot findings indicate that the PICHA7 program has high user acceptability and is feasible to deliver to cholera patients that present at health facilities for treatment in our study setting. Formative research allowed for tailoring this targeted WASH program for cholera patient households in the DRC.

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Section: Discussionsupporting

confidence: 86%

Formative Research for the Development of Evidence-Based Targeted Water, Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo: Preventative Intervention for Cholera for 7 Days (PICHA7) Program

Bisimwa

Williams

Bisimwa

et al. 2022

IJERPH

Self Cite

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Impact of Water, Sanitation, and Hygiene (WaSH) interventions on diarrhoeal infections among children in the tribal regions of Palghar: a quasi-experimental study

Jeyakumar,

Giri,

Godbharle

2024

Journal of Water and Health

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This study tested the effect of a 4-week Water, Sanitation, and Hygiene (WaSH) intervention on diarrhoeal infections in children, and knowledge, awareness, practices (KAP) in the six tribal villages of Palghar. We performed a quasi-experimental study in N = 180 households among mothers with children under-five registered in the anganwadi centers. Households received either WaSH kits (control arm n = 90) or kits combined with education (intervention arm n = 90). We estimated the effect of this 4-week intervention by comparing the groups post-intervention for change in KAP and diarrhoea infection. The average overall KAP score of the intervention group increased significantly from 8.54 ± 1.65 to 11.89 ± 1.60 (p < 0.001), between pre-intervention (t0) and 4 weeks after intervention (t2). In the control group, the change in average overall KAP score was not statistically significant (8.39 ± 1.72 to 8.74 ± 1.76 (p = 0.764)), between the t0 and t2 assessments. Diarrhoeal infection was reduced by 6% in the intervention compared to 2% in the control group. These findings support that a combination of short- and long-term strategies was more effective in reducing diarrhoea among tribal children than standalone approaches.

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Diarrheal Disease Awareness Is Associated with Caregiver Handwashing with Soap in the Democratic Republic of the Congo (REDUCE Program)

Cited by 2 publications

References 25 publications

Formative Research for the Development of Evidence-Based Targeted Water, Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo: Preventative Intervention for Cholera for 7 Days (PICHA7) Program

Formative Research for the Development of Evidence-Based Targeted Water, Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo: Preventative Intervention for Cholera for 7 Days (PICHA7) Program

Impact of Water, Sanitation, and Hygiene (WaSH) interventions on diarrhoeal infections among children in the tribal regions of Palghar: a quasi-experimental study

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