Use of nutritional and water hygiene packages for diarrhoeal prevention among HIV-exposed infants in Lilongwe, Malawi: an evaluation of a pilot prevention of mother-to-child transmission post-natal care service

Xue, Jiayin; Mhango, Zenabu; Hoffman, Irving; Mofolo, Innocent; Kamanga, Esmie; Campbell, James T.; Allgood, Greg; Cohen, Myron S.; Martinson, Francis; Miller, William C.; Hosseinipour, Mina C.

doi:10.1111/j.1365-3156.2010.02595.x

Cited by 10 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies of LifeStraw filters reported 68% use 8 months after distribution (Boisson et al 2010) and 83% use 2 months after distribution LifeStraw Family and LifeStraw personal filters combined) [51]. Furthermore, it is possible that use may be particularly high among HIV-positive mothers with young children because of increased concern and awareness of health; chlorination use has been found to be high among similar populations [25], [29].…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia

et al. 2012

View full text Add to dashboard Cite

BackgroundUnsafe drinking water presents a particular threat to people living with HIV/AIDS (PLHIV) due to the increased risk of opportunistic infections, diarrhea-associated malabsorption of essential nutrients, and increased exposure to untreated water for children of HIV-positive mothers who use replacement feeding to reduce the risk of HIV transmission. This population may particularly benefit from an intervention to improve water quality in the home.Methods and FindingsWe conducted a 12-month randomized, controlled field trial in Zambia among 120 households with children <2 years (100 with HIV-positive mothers and 20 with HIV-negative mothers to reduce stigma of participation) to assess a high-performance water filter and jerry cans for safe storage. Households were followed up monthly to assess use, drinking water quality (thermotolerant coliforms (TTC), an indicator of fecal contamination) and reported diarrhea (7-day recall) among children <2 years and all members of the household. Because previous attempts to blind the filter have been unsuccessful, we also assessed weight-for-age Z-scores (WAZ) as an objective measure of diarrhea impact. Filter use was high, with 96% (596/620) of household visits meeting the criteria for users. The quality of water stored in intervention households was significantly better than in control households (3 vs. 181 TTC/100 mL, respectively, p<0.001). The intervention was associated with reductions in the longitudinal prevalence of reported diarrhea of 53% among children <2 years (LPR = 0.47, 95% CI: 0.30–0.73, p = 0.001) and 54% among all household members (LPR = 0.46, 95% CI: 0.30–0.70, p<0.001). While reduced WAZ was associated with reported diarrhea (−0.26; 95% CI: −0.37 to −0.14, p<0.001), there was no difference in WAZ between intervention and control groups.ConclusionIn this population living with HIV/AIDS, a water filter combined with safe storage was used correctly and consistently, was highly effective in improving drinking water quality, and was protective against diarrhea.Trial RegistrationClinicaltrials.gov NCT01116908

show abstract

Section: Discussionmentioning

confidence: 98%

“…International organizations including USAID, the World Bank, and WHO have recently called for an integration of water and sanitation activities in HIV/AIDS programs [17], [18], [19], [20], and the number of programs including HWTS for PLHIV is increasing [21], [22], [23], [24], [25], [26].…”

Section: Introductionmentioning

confidence: 99%

Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia

et al. 2012

View full text Add to dashboard Cite

show abstract

“…18 Furthermore, use may be particularly high among HIV-positive mothers with young children because of increased concern and awareness of health; chlorination use has been found to be high among similar populations. 19,20 It is also possible that filter use was higher because local health staff used during the RCT continued to reside and work in the project areas after that RCT terminated.…”

Section: Discussionmentioning

confidence: 99%

Follow-Up Study to Assess the Use and Performance of Household Filters in Zambia

Peletz¹,

Simuyandi²,

Simunyama³

et al. 2013

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Effective household water treatment can improve drinking water quality and prevent disease if used correctly and consistently over time. One year after completion of a randomized controlled study of water filters among households in Zambia with children 2 years old and mothers who were human immunodeficiency virus (HIV)-positive, we conducted a follow-up study to assess use and performance of new filters distributed at the conclusion of the study; 90% of participating households met the criteria for current users, and 75% of participating households had stored water with lower levels of fecal contamination than source water. Microbiologically, the filters continued to perform well, removing an average of 99.0% of fecal indicator bacteria. Although this study provides some encouraging evidence about the potential to maintain high uptake and filter performance, even in the absence of regular household visits, additional research is necessary to assess whether these results can be achieved over longer periods and with larger populations.

show abstract

“…This finding is consistent with other research, which reported that children under 2 years were five times as likely to have diarrhea if their mother had diarrhea ( P < 0.001). 39 This association is of particular concern in HIV-affected areas; mothers with HIV may be more likely to have diarrhea and therefore, more likely to pass diarrhea onto their children. Previous research found that HIV-positive adults are seven times more likely to have diarrhea and HIV-positive children under 5 years are four times more likely to have diarrhea compared with HIV-negative individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Although the research is limited, there is promising evidence that both children born to HIV-positive mothers and PLHIV may benefit from safe drinking water and other environmental health improvements. 39,[42][43][44] In areas where the source water is of relatively good quality, such as in some of our study sites, protecting drinking water during storage may be sufficient to ensure household water quality. Safe storage containers have the potential to substantially reduce recontamination of drinking water in the household at low cost and subsequently, reduce diarrheal disease.…”

Section: Discussionmentioning

confidence: 99%

Drinking Water Quality, Feeding Practices, and Diarrhea among Children under 2 Years of HIV-Positive Mothers in Peri-Urban Zambia

Peletz¹,

Simuyandi²,

Sarenje³

et al. 2011

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

In low-income settings, human immunodeficiency virus (HIV)-positive mothers must choose between breastfeeding their infants and risking transmission of HIV or replacement feeding their infants and risking diarrheal disease from contaminated water. We conducted a cross-sectional study of children < 2 years of age of 254 HIV-positive mothers in peri-urban Zambia to assess their exposure to waterborne fecal contamination. Fecal indicators were found in 70% of household drinking water samples. In a multivariable analysis, factors associated with diarrhea prevalence in children < 2 years were mother having diarrhea (adjusted odds ratio [aOR] = 5.18, 95% confidence interval [CI] = 1.65–16.28), child given water in the past 2 days (aOR = 4.08, 95% CI = 1.07–15.52), child never being breastfed (aOR = 2.67, 95% CI = 1.06–6.72), and rainy (versus dry) season (aOR = 4.60, 95% CI = 1.29–16.42). Children born to HIV-positive mothers were exposed to contaminated water through direct intake of drinking water, indicating the need for interventions to ensure microbiological water quality.

show abstract

Use of nutritional and water hygiene packages for diarrhoeal prevention among HIV-exposed infants in Lilongwe, Malawi: an evaluation of a pilot prevention of mother-to-child transmission post-natal care service

Cited by 10 publications

References 16 publications

Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia

Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia

Follow-Up Study to Assess the Use and Performance of Household Filters in Zambia

Drinking Water Quality, Feeding Practices, and Diarrhea among Children under 2 Years of HIV-Positive Mothers in Peri-Urban Zambia

Contact Info

Product

Resources

About