Poultry Management and Child Diarrhea in Uganda

Improving Hygienic Management of Poultry in Rural Uganda

Fecal contamination from animal sources, specifically chickens, is increasingly recognized as a risk factor for enteric infections in low-income countries where domestic animals are often kept in close proximity to living quarters. Community members typically allow chickens to move freely around their compound and in their homes. Unlike other animals, such as cows or goats, poultry are typically not confined and their feces, which are relatively small, are considered relatively innocuous and therefore largely ignored by adults and children. In this study, the investigators have implemented an intervention to help rural poultry owners with children to hygienically separate chickens from children by focusing on a small set of key factors, including increased risk perception, increased perception of potential livelihood benefits, increased skills, and increased supportive social norms. The investigators hypothesized that the poultry hygiene intervention will lead to improved poultry management practices, which will in turn lead to reduced fecal contamination in the domestic environment and subsequently reduced diarrheal illness in young children. To measure these parameters along the causal chain, the investigators used a combination of household surveys, spot check observations and testing of environmental samples for fecal contamination.

Study Overview

• Status: Completed
• Conditions: Diarrhea
• Intervention / Treatment: Behavioral: Poultry hygiene intervention

• Study Type: Interventional
• Enrollment (Actual): 1307
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Uganda
  • Kampala, Uganda
    • The Water Trust

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• At least one person in the household is a member of Self-Help Groups formed by The Water Trust, Uganda
• There is at least one child under the age of 5 years living in the household
• There is an adult (>18 years) primary caregiver of a child <5 years available for participation in study

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: PREVENTION
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Intervention arm; This arm received the poultry hygiene intervention.	Behavioral: Poultry hygiene intervention; The intervention will consist of a series of participatory training exercises designed to accomplish three main goals: (1) increase awareness of health risks and lost livelihood benefits of current poultry management practices, (2) build practical skills for poultry management, and (3) build supportive community norms by facilitating savings group discussions on poultry management. The intervention will be delivered through three activities: (1) triggering exercise designed to raise awareness of both the health risks of the current practices and the economic potential of a more active poultry management approach, and ultimately to motivate participants for behavior change, (2) poultry management training activity based on local needs and norms, and (3) periodic follow-on coaching to reinforce messages from the initial training and emphasize action planning, monitoring of plan execution, and troubleshooting.
NO_INTERVENTION: Control arm; This arm received no intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of children <5 years with caregiver-reported diarrhea in past 7 days	Diarrhea defined as 3 or more soft or watery stools in 24-hour period	Caregiver reported 7-day prevalence of diarrhea in children <5 years, measured approximately 1 year after initiation of intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of households with E.coli in household environmental samples	Detection of E. coli (general fecal indicator)	Ascertained with analysis of samples from households, collected approximately 1 year after initiation of intervention
Proportion of households with observed poultry feces in compound	Poultry feces occurrences observed in household compounds	Ascertained by spot check observation approximately 1 year after initiation of intervention

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of children <5 years with caregiver-reported respiratory infection in past 7 days	Respiratory infection defined as any of the following symptoms: Constant cough, congestion, runny nose, panting, wheezing, or difficulty breathing	Caregiver reported 7-day prevalence of respiratory infection in children <5 years, measured approximately 1 year after initiation of intervention

Collaborators and Investigators

• Sponsor: North Carolina State University
• Collaborators: The Water Trust
• Investigators: Principal Investigator: Ayse Ercumen, North Carolina State University; Principal Investigator: Angela Harris, North Carolina State University; Study Director: Chris Prottas, The Water Trust

Study record dates

Study Major Dates

• Study Start (ACTUAL): September 1, 2019
• Primary Completion (ACTUAL): August 25, 2021
• Study Completion (ACTUAL): August 25, 2021

Study Registration Dates

• First Submitted: October 2, 2020
• First Submitted That Met QC Criteria: October 2, 2020
• First Posted (ACTUAL): October 8, 2020

Study Record Updates

• Last Update Posted (ACTUAL): March 23, 2022
• Last Update Submitted That Met QC Criteria: March 8, 2022
• Last Verified: March 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Signs and Symptoms, Digestive; Diarrhea
• Other Study ID Numbers: 698

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No