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

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Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial Prof Stephen P Luby, MD, Mahbubur Rahman, MBBS, Benjamin F Arnold, PhD, Leanne Unicomb, PhD, Sania Ashraf, MPH, Prof Peter J Winch, MD, Christine P Stewart, PhD, Farzana Begum, MPH, Faruqe Hussain, MSS, Jade Benjamin-Chung, PhD, Elli Leontsini, MD, Abu M Naser, MBBS, Sarker M Parvez, MPH, Prof Alan E Hubbard, PhD, Audrie Lin, PhD, Fosiul A Nizame, MA, Kaniz Jannat, MBBS, Ayse Ercumen, PhD, Pavani K Ram, MD, Kishor K Das, MS, Jaynal Abedin, MS, Prof Thomas F Clasen, PhD, Prof Kathryn G Dewey, PhD, Prof Lia C Fernald, Clair Null, PhD, Tahmeed Ahmed, PhD, Prof John M Colford, MD The Lancet Global Health Volume 6, Issue 3, Pages e302-e315 (March 2018) DOI: 10.1016/S2214-109X(17)30490-4 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. The Lancet Global Health 2018 6, e302-e315DOI: (10.1016/S2214-109X(17)30490-4) 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 in index children and children younger than 3 years at enrolment 1 and 2 years after intervention Data are mean (95% CI). ref=reference. WSH=water, sanitation, and handwashing. The Lancet Global Health 2018 6, e302-e315DOI: (10.1016/S2214-109X(17)30490-4) 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 4584 children after 2 years of intervention Kernel density plots show the distribution of length-for-age Z scores among index children who were born into the study and were aged 18–28 months (median 22, IQR 21–24) at the time of measurement. Dashed lines are the comparison group distribution and solid lines are the active comparator distribution. (A) Water vs control. (B) Sanitation vs control. (C) Handwashing vs control. (D) WSH vs control. (E) Nutrition vs control. (F) WSH and nutrition vs control. (G) WSH and nutrition vs nutrition. (H) WSH and nutrition vs WSH. WSH=water, sanitation, and handwashing. The Lancet Global Health 2018 6, e302-e315DOI: (10.1016/S2214-109X(17)30490-4) 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