The Effect of an Urban Sanitation Intervention on Child Health
The Effect of an Urban Sanitation Intervention on Child Health
The purpose of this study is to determine the health impact of a basic sanitation
 intervention in Maputo, Mozambique.
We have designed a controlled, before-and-after (CBA) effectiveness study to estimate the
 health impacts of an urban sanitation intervention in informal neighborhoods of Maputo,
 Mozambique, including an assessment of whether exposures and health outcomes vary by
 localized population density. The intervention consists of private pour-flush latrines (to
 septic tank) shared by multiple households in compounds or household clusters. We will
 measure objective health outcomes in approximately 1000 children (500 children with household
 access to interventions, 500 controls using existing shared private latrines in poor sanitary
 conditions), at two time points: immediately before the intervention and at follow-up after
 12 months. The primary outcome is combined prevalence of enteric infections among children
 under 5 years of age. Secondary outcome measures include soil transmitted helminth (STH)
 re-infection in children following baseline de-worming and prevalence of reported
 gastrointestinal illness. We will use exposure assessment, fecal source tracking, and
 microbial transmission modeling to examine whether and how routes of exposure for
 diarrheagenic pathogens and STHs vary and transmission impacts of the pathogens following
 introduction of effective sanitation. Our analysis will focus specifically on the impact of
 localized population density as a potential modifier of sanitation-related exposures.
Inclusion Criteria:

 -  Children normally resident in households with access to new shared sanitation (the
 intervention) as selected by implementing organisation (WSUP) or control children
 normally resident in households sharing existing shared sanitation within
 geographically delimited project bounds and meeting WSUP site selection criteria
 (including number of people served)

 Exclusion Criteria:

 -  Refusal to participate