A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste

the WASH for WORMS research protocol

Susana Vaz Nery, James S. McCarthy, Rebecca Traub, Ross M. Andrews, Jim Black, Darren Gray, Edmund Weking, Jo An Atkinson, Suzy Campbell, Naomi Francis, Andrew Vallely, Gail Williams, Archie Clements

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    Abstract

    Introduction: There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. 

    Methods and analysis: WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. 

    Ethics and dissemination: Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes.

    Original languageEnglish
    Article numbere009293
    Pages (from-to)1-12
    Number of pages12
    JournalBMJ Open
    Volume5
    Issue number12
    DOIs
    Publication statusPublished - Dec 2015

    Fingerprint

    Albendazole
    Sanitation
    Hygiene
    Helminths
    Parasites
    Randomized Controlled Trials
    Water
    Soil
    Research
    Infection
    Ethics
    Growth Disorders
    Ethics Committees
    Queensland
    Health
    Rural Population
    Timor-Leste
    Anemia
    Hemoglobins
    Morbidity

    Cite this

    Nery, Susana Vaz ; McCarthy, James S. ; Traub, Rebecca ; Andrews, Ross M. ; Black, Jim ; Gray, Darren ; Weking, Edmund ; Atkinson, Jo An ; Campbell, Suzy ; Francis, Naomi ; Vallely, Andrew ; Williams, Gail ; Clements, Archie. / A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste : the WASH for WORMS research protocol. In: BMJ Open. 2015 ; Vol. 5, No. 12. pp. 1-12.
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    title = "A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol",
    abstract = "Introduction: There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. Methods and analysis: WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics and dissemination: Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes.",
    author = "Nery, {Susana Vaz} and McCarthy, {James S.} and Rebecca Traub and Andrews, {Ross M.} and Jim Black and Darren Gray and Edmund Weking and Atkinson, {Jo An} and Suzy Campbell and Naomi Francis and Andrew Vallely and Gail Williams and Archie Clements",
    note = "This study is funded by a Partnership for Better Health—Project grant from the Australian National Health and Research Council (NHMRC (APP1013713). DG holds a NHMRC Career Development Fellowship (APP1090221); AC holds a NHMRC Senior Research Fellowship (APP1058878).",
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    A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste : the WASH for WORMS research protocol. / Nery, Susana Vaz; McCarthy, James S.; Traub, Rebecca; Andrews, Ross M.; Black, Jim; Gray, Darren; Weking, Edmund; Atkinson, Jo An; Campbell, Suzy; Francis, Naomi; Vallely, Andrew; Williams, Gail; Clements, Archie.

    In: BMJ Open, Vol. 5, No. 12, e009293, 12.2015, p. 1-12.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste

    T2 - the WASH for WORMS research protocol

    AU - Nery, Susana Vaz

    AU - McCarthy, James S.

    AU - Traub, Rebecca

    AU - Andrews, Ross M.

    AU - Black, Jim

    AU - Gray, Darren

    AU - Weking, Edmund

    AU - Atkinson, Jo An

    AU - Campbell, Suzy

    AU - Francis, Naomi

    AU - Vallely, Andrew

    AU - Williams, Gail

    AU - Clements, Archie

    N1 - This study is funded by a Partnership for Better Health—Project grant from the Australian National Health and Research Council (NHMRC (APP1013713). DG holds a NHMRC Career Development Fellowship (APP1090221); AC holds a NHMRC Senior Research Fellowship (APP1058878).

    PY - 2015/12

    Y1 - 2015/12

    N2 - Introduction: There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. Methods and analysis: WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics and dissemination: Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes.

    AB - Introduction: There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. Methods and analysis: WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics and dissemination: Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes.

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    JO - BMJ Open

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