Study design and rationale for the PAASIM project: a matched cohort study on urban water supply improvements and infant enteric pathogen infection, gut microbiome development and health in Mozambique

被引：0

作者：

Levy, Karen ^{[1
,2
]}

Garn, Joshua, V ^{[3
]}

Cumbe, Zaida Adriano ^{[4
]}

Muneme, Bacelar ^{[4
]}

Fagnant-Sperati, Christine S. ^{[1
]}

Hubbard, Sydney ^{[2
]}

Junior, Antonio ^{[4
]}

Manuel, Joao Luis ^{[5
]}

Mangamela, Magalhaes ^{[6
]}

McGunegill, Sandy ^{[2
]}

Miller-Petrie, Molly K. ^{[1
]}

Snyder, Jedidiah S. ^{[2
]}

Victor, Courtney ^{[2
]}

Waller, Lance A. ^{[7
]}

Konstantinidis, Konstantinos T. ^{[8
]}

Clasen, Thomas F. ^{[2
]}

Brown, Joe ^{[9
]}

Nala, Rassul ^{[10
]}

Freeman, Matthew C. ^{[2
]}

机构：

[1] Univ Washington, Dept Environm & Occupat Hlth Sci, Sch Publ Hlth, Seattle, WA 98195 USA

[2] Emory Univ, Rollins Sch Publ Hlth, Gangarosa Dept Environm Hlth, Atlanta, GA 30322 USA

[3] Univ Nevada Reno, Sch Publ Hlth, Div Biostat Epidemiol & Environm Hlth, Reno, NV USA

[4] WE Consult, Maputo, Mozambique

[5] Minist Hlth Mozamb, Natl Hlth Inst INS, Beira Operat Res Ctr, Beira, Mozambique

[6] Autoridade Reguladora Agua, Inst Publ, Maputo, Mozambique

[7] Emory Univ, Rollins Sch Publ Hlth, Dept Biostat & Bioinformat, Atlanta, GA USA

[8] Georgia Inst Technol, Sch Civil & Environm Engn, Atlanta, GA USA

[9] Univ North Carolina Chapel Hill, Environm Sci & Engn, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA

[10] Minist Hlth, Inst Nacl Saude, Marracuene, Mozambique

来源：

BMJ OPEN | 2023年 / 13卷 / 03期

关键词：

gastrointestinal infections; public health; epidemiology; RANDOMIZED CONTROLLED-TRIAL; MIDDLE-INCOME COUNTRIES; DRINKING-WATER; DIARRHEAL DISEASES; NUTRITIONAL INTERVENTIONS; INTESTINAL PERMEABILITY; CHILD UNDERNUTRITION; SANITATION; GROWTH; IMPACT;

D O I：

10.1136/bmjopen-2022-067341

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction Despite clear linkages between provision of clean water and improvements in child health, limited information exists about the health impacts of large water infrastructure improvements in low-income settings. Billions of dollars are spent annually to improve urban water supply, and rigorous evaluation of these improvements, especially targeting informal settlements, is critical to guide policy and investment strategies. Objective measures of infection and exposure to pathogens, and measures of gut function, are needed to understand the effectiveness and impact of water supply improvements. Methods and analysis In the PAASIM study, we examine the impact of water system improvements on acute and chronic health outcomes in children in a low-income urban area of Beira, Mozambique, comprising 62 sub-neighbourhoods and similar to 26 300 households. This prospective matched cohort study follows 548 mother-child dyads from late pregnancy through 12 months of age. Primary outcomes include measures of enteric pathogen infections, gut microbiome composition and source drinking water microbiological quality, measured at the child's 12-month visit. Additional outcomes include diarrhoea prevalence, child growth, previous enteric pathogen exposure, child mortality and various measures of water access and quality. Our analyses will compare (1) subjects living in sub-neighbourhoods with the improved water to those living in sub-neighbourhoods without these improvements; and (2) subjects with household water connections on their premises to those without such a connection. This study will provide critical information to understand how to optimise investments for improving child health, filling the information gap about the impact of piped water provision to low-income urban households, using novel gastrointestinal disease outcomes. Ethics and dissemination This study was approved by the Emory University Institutional Review Board and the National Bio-Ethics Committee for Health in Mozambique. The pre-analysis plan is published on the Open Science Framework platform (https://osf.io/4rkn6/). Results will be shared with relevant stakeholders locally, and through publications.

引用

页数：15