Table 3. Effect of intervention on bacterial, protozoan, viral, and STH infection and reported diarrhea in children born into study sites post-intervention (post-baseline) but by 24-month visit compared with children of a similar age at baseline (<2 years old).
| Prevalence (<2 years old) | Prevalence ratio (95% CI), p-value | |||
|---|---|---|---|---|
| Baseline | 24 month, Born-in | Unadjusted | Adjusted† | |
| Any bacterial or protozoan infection* | ||||
| Control | 158/228 (69%) | 79/106 (75%) | .. | .. |
| Intervention | 129/201 (64%) | 71/107 (66%) | 0.96 (0.77–1.21), p=0.74 | 0.99 (0.80–1.22), p=0.92 |
| Any STH infection* | ||||
| Control | 67/205 (33%) | 25/68 (37%) | .. | .. |
| Intervention | 52/183 (28%) | 13/75 (17%) | 0.52 (0.26–1.05), p=0.069 | 0.51 (0.27–0.95), p=0.035 |
| Diarrhea* | ||||
| Control | 46/283 (16%) | 18/105 (17%) | .. | .. |
| Intervention | 43/238 (18%) | 22/100 (22%) | 1.20 (0.57–2.5), p=0.64 | 1.37 (0.47–4.03), p=0.57 |
| Any bacteria | ||||
| Control | 142/228 (62%) | 70/106 (66%) | .. | .. |
| Intervention | 102/201 (51%) | 51/107 (48%) | 0.89 (0.66–1.20), p=0.44 | 0.90 (0.67–1.19), p=0.45 |
| Shigella | ||||
| Control | 67/228 (29%) | 36/106 (34%) | .. | .. |
| Intervention | 49/201 (24%) | 15/107 (14%) | 0.48 (0.28–0.83), p=0.009 | 0.49 (0.28–0.85), p=0.011 |
| ETEC | ||||
| Control | 70/228 (31%) | 30/106 (28%) | .. | .. |
| Intervention | 58/201 (29%) | 24/107 (22%) | 0.84 (0.46–1.52), p=0.56 | 0.85 (0.48–1.51), p=0.58 |
| Campylobacter | ||||
| Control | 27/228 (12%) | 14/106 (13%) | .. | .. |
| Intervention | 14/201 (7%) | 13/107 (12%) | 1.75 (0.63–4.87), p=0.29 | 1.75 (0.61–4.98), p=0.30 |
| C. difficile | ||||
| Control | 20/228 (8.8%) | 7/106 (6.6%) | .. | .. |
| Intervention | 13/201 (6.5%) | 7/107 (6.5%) | 1.33 (0.36–4.86), p=0.67 | 1.49 (0.41–5.44), p=0.55 |
| E. coli O157 | ||||
| Control | 7/228 (3.1%) | 3/106 (2.8%) | .. | .. |
| Intervention | 9/201 (4.5%) | 2/107 (1.9%) | 0.45 (0.06–3.66), p=0.46 | 0.53 (0.07–4.24), p=0.55 |
| STEC | ||||
| Control | 1/228 (0.44%) | 2/106 (1.9%) | .. | .. |
| Intervention | 9/201 (4.5%) | 1/107 (0.93%) | 0.05 (0.00–1.13), p=0.059 | 0.05 (0.00–1.26), p=0.070 |
| Any protozoa | ||||
| Control | 82/228 (36%) | 47/106 (44%) | .. | .. |
| Intervention | 74/201 (37%) | 43/107 (40%) | 0.84 (0.55–1.28), p=0.42 | 0.90 (0.62–1.30), p=0.58 |
| Giardia | ||||
| Control | 79/228 (35%) | 44/106 (42%) | .. | .. |
| Intervention | 68/201 (34%) | 41/107 (38%) | 0.90 (0.58–1.39), p=0.63 | 0.93 (0.64–1.36), p=0.70 |
| Cryptosporidium | ||||
| Control | 7/228 (3.1%) | 5/106 (4.7%) | .. | .. |
| Intervention | 12/201 (6%) | 5/107 (4.7%) | 0.45 (0.08–2.57), p=0.37 | 0.64 (0.12–3.51), p=0.61 |
| Any virus | ||||
| Control | 34/228 (15%) | 18/106 (17%) | .. | .. |
| Intervention | 36/201 (18%) | 18/107 (17%) | 0.83 (0.37–1.83), p=0.64 | 0.83 (0.37–1.87), p=0.66 |
| Norovirus GI/GII | ||||
| Control | 26/228 (11%) | 12/106 (11%) | .. | .. |
| Intervention | 26/201 (13%) | 17/107 (16%) | 1.24 (0.48–3.17), p=0.66 | 1.29 (0.49–3.41), p=0.61 |
| Adenovirus 40/41 | ||||
| Control | 7/228 (3.1%) | 4/106 (3.8%) | .. | .. |
| Intervention | 7/201 (3.5%) | 0/107 (0.0%) | ..§ | ..§ |
| Coinfection, ≥2 GPP pathogens | ||||
| Control | 92/228 (40%) | 52/106 (49%) | .. | .. |
| Intervention | 74/201 (37%) | 39/107 (36%) | 0.82 (0.56–1.21), p=0.33 | 0.86 (0.59–1.24), p=0.41 |
| Trichuris | ||||
| Control | 48/205 (23%) | 18/68 (26%) | .. | .. |
| Intervention | 41/183 (22%) | 5/75 (6.7%) | 0.25 (0.09–0.68), p=0.006 | 0.24 (0.10–0.60), p=0.002 |
| Ascaris | ||||
| Control | 45/205 (22%) | 16/68 (24%) | .. | .. |
| Intervention | 29/183 (16%) | 9/75 (12%) | 0.70 (0.30–1.64), p=0.42 | 0.68 (0.30–1.54), p=0.36 |
| Coinfection, ≥2 STH | ||||
| Control | 26/205 (13%) | 9/68 (13%) | .. | .. |
| Intervention | 18/183 (9.8%) | 1/75 (1.3%) | 0.13 (0.02–1.08), p=0.059 | 0.12 (0.01–1.02), p=0.052 |
Analysis includes children < 2 years old at baseline and children born into the study after baseline and <2 years old at the time of the 24-month visit. Prevalence results are presented as (n/N (%)). All effect estimates are presented as prevalence ratios (ratio of ratios) and estimated using generalized estimating equations to fit Poisson regression models with robust standard errors.
*Outcome was pre-specified in trial registration. All other outcomes are exploratory.
†Pathogen outcomes adjusted for child age and sex, caregiver’s education, and household wealth index. Reported diarrhea was also adjusted for baseline presence of a drop-hole cover and reported use of a tap on compound grounds as primary drinking water source. Sample sizes for adjusted analyses are slightly smaller than numbers presented in prevalence estimates due to missing covariate data.
§Models would not converge due to sparse data. Y. enterocolitica, V. cholerae, E. histolytica, and rotavirus were detected in <2% of samples in each arm at each phase and excluded. Descriptive data for these pathogens are available in the Appendix 1—table 2. Source files available in Table 3—source data 1 and Table 3—source code 1.