Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled.

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Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial Clair Null, PhD, Christine P Stewart, PhD, Amy J Pickering, PhD, Holly N Dentz, MPH, Benjamin F Arnold, PhD, Charles D Arnold, MS, Jade Benjamin-Chung, PhD, Prof Thomas Clasen, PhD, Prof Kathryn G Dewey, PhD, Prof Lia C H Fernald, PhD, Alan E Hubbard, PhD, Patricia Kariger, PhD, Audrie Lin, PhD, Stephen P Luby, MD, Andrew Mertens, MS, Sammy M Njenga, PhD, Geoffrey Nyambane, MA, Pavani K Ram, MD, Prof John M Colford, MD The Lancet Global Health Volume 6, Issue 3, Pages e316-e329 (March 2018) DOI: 10.1016/S2214-109X(18)30005-6 Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 Trial profile and analysis populations for primary outcomes LAZ=length-for-age Z scores. *Stillbirth and child death counts are cumulative. The Lancet Global Health 2018 6, e316-e329DOI: (10.1016/S2214-109X(18)30005-6) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Intervention effects on diarrhoea prevalence 1 and 2 years after intervention Data are mean (95% CI). ref=reference. WSH=water, sanitation, and handwashing. The Lancet Global Health 2018 6, e316-e329DOI: (10.1016/S2214-109X(18)30005-6) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 Intervention effects on length-for-age Z scores in 6583 children after 2 years of intervention Kernel density plots show the distribution of length-for-age Z scores; dashed lines are the comparison group distribution and solid lines are the active comparator distribution. (A) Passive control vs active control. (B) Water vs active control. (C) Sanitation vs active control. (D) Handwashing vs active control. (E) WSH vs active control. (F) Nutrition vs active control. (G) WSH and nutrition vs active control. (H) WSH and nutrition vs nutrition. (I) WSH and nutrition vs WSH. p values for t test are for differences in group means from zero; permutation p values test the null hypothesis of no difference between groups using a Wilcoxon signed-rank test statistic. WSH=water, sanitation, and handwashing. The Lancet Global Health 2018 6, e316-e329DOI: (10.1016/S2214-109X(18)30005-6) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions