News ID: 209608
Published: 0816 GMT February 07, 2018

Radically cleaner environment may be essential to cut childhood stunting

Radically cleaner environment may be essential to cut childhood stunting
borgenproject.org

Improved drinking water, sanitation and handwashing (WASH) interventions reduced child diarrhoea in rural Bangladesh, but contrary to expectations, did not impact child growth — indicates findings from new study by International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and US collaborators.

Published in the Lancet Global Health, finding from the WASH Benefits study conducted by (ICDDR,B) researchers with support from a broad range of international collaborators explored how a combination of chlorinated drinking water, upgraded sanitation and handwashing promotion with nutritional supplements coupled with dietary counseling altogether or individually affects the health and wellbeing of children under two years of age, reliefweb.int reported.

The study achieved high uptake of the water, sanitation, handwashing and nutrition interventions, with a clear interruption of pathogen transmission, illustrated by the reduction in diarrhoea.

The nutrition intervention modestly improved child’s height, but none of the WASH interventions improved height or reduced stunting, that is being short for age.

Scientists from Stanford University; University of California, Berkeley; Johns Hopkins Bloomberg School of Public Health; the University of California, Davis; the University of Buffalo and Emory University were co-investigators and authors of the research supported by the Bill & Melinda Gates Foundation.

Children in the Bangladesh trial who received nutritional supplements in addition to WASH interventions did grow taller and were 38 percent less likely to die during the study, but WASH interventions alone without nutrition did not improve growth.

The intervention reduced contamination of food and water, fewer flies and improved diet, nevertheless soil in the study area was still heavily contaminated.

“Even with high uptake, these interventions apparently did not clean the environment enough to impact child growth. If we want children in the most resource-constrained environments to thrive, we may need to make their environments radically cleaner,” observed Stanford Professor Stephen Luby, senior author of the study.

Professor Luby is one of the first epidemiologists to examine WASH interventions as a way of improving children’s growth in resource-limited communities. He observes that the findings help to inform future efforts, by focusing on strategies that can provide more than modest improvements to environments.

Commenting on the findings, Dr. Md. Mahbubur Rahman, (ICDDR,B) principal investgator of the study in Bangladesh, said, “It was shown again that conventional WASH intervention strategies are insufficient to improve stunting in children living in WASH-compromised settings.”

He feels it is the time to think about more comprehensive strategies for WASH interventions that can better ensure clean and safe environments for growing children.

Future studies need to examine ways to reduce children’s exposure to fecal contamination in and around the home, recommends Rahman, who also leads the environmental health and interventions unit at (ICDDR,B) as a project coordinator.

“We also need to learn how to effectively integrate these WASH interventions with other interventions for maternal and child health nutrition, and psychosocial stimulation to product the very best outcomes for our children,” he adds.

   
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