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An inter-disciplinary approach to understanding the contribution of household flooring to disease burden in rural Kenya


Department for International Development UKAID

Titre : An inter-disciplinary approach to understanding the contribution of household flooring to disease burden in rural Kenya

Pays : Kenya

Numéro du projet : GB-GOV-13-FUND—GCRF-MR_T029811_1

Organismes de mise en œuvre : London Sch of Hygiene and Trop Medicine

Durée : Actual Start 01 Oct 2020 // Planned End31 Mar 2023

Objectif partiel
The proposed research will answer the question : do rudimentary (earth, sand or dirt) domestic floors play an important role in the transmission of infection in rural communities, and are there effective intervention strategies to mitigate this risk ? Our proposed trial would be the first study of its kind, providing an important step towards the establishment of transformative, community-driven, integrated approaches to environmental health. Specific Objectives : 1. To determine the role played by rudimentary floors in the transmission of enteric pathogens, soil-transmitted helminths and tungiasis in rural Kenyan communities. This includes describing how water and sanitation infrastructure, domestic hygiene behaviours, animal husbandry practices, and wider socio-cultural and environmental contexts, influence this relationship. 2. To develop and implement contextually relevant interventions to mitigate the effects of rudimentary flooring on infectious diseases in rural Kenya. We envisage these will comprise replacing existing floors with an improved (sealed, washable and durable) floor, accompanied by a participant-informed behaviour change programme to promote floor cleaning and maintenance and improve associated domestic hygiene. Within this objective, we intend to : i) describe the roles of planned, motivated and reactive behaviours in relation to domestic hygiene and explore how these are influenced by wider socio-cultural and environmental contexts ; ii) explore the structural, economic and household requirements and end-user preferences for low-cost improved flooring technology ; iii) characterise the pathways through which socio-cultural and environmental contextual factors influence the final intervention design ; 3. To evaluate the effect of the interventions on individual-level risk of enteric, STH and tungiasis infection, and explore how this varies with local context. This will be conducted in three settings across Kenya, and includes to : i) Assess changes in prevalence of enteric infections, STH and tungiasis, and the incidence of self-reported gastrointestinal illness in children ; ii) Quantify changes in entero-pathogen and parasitic contamination levels in sleeping and communal resting areas ; iii) Explore how intervention effects differ across community and household contexts (including WASH infrastructure, animal husbandry practices) ; iv) Assess additional health and quality of life changes, including subjective wellbeing, in both children and their caregivers ; v) Characterise causal pathways linking intervention activities to health and behaviour outcomes, and explore the roles played by mediating contextual factors ; vi) Assess the extent to which interventions are acceptable to target communities, feasible given existing resource constraints, and can be scaled-up across Kenya and elsewhere

Financement : UK - Department for Business, Energy and Industrial Strategy
Project budget : £2,011,329

Présentation (UKAID)

Page publiée le 15 octobre 2022