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Effect of a Homestead Food Production Program on the Prevalence of Diarrhea and Acute Respiratory Infection in Children in Sylhet, Bangladesh: A Cluster-Randomized Controlled Trial

Authors
/persons/resource/Nathalie.Lambrecht

Lambrecht,  Nathalie
Potsdam Institute for Climate Impact Research;

/persons/resource/anna.mueller

Müller-Hauser,  Anna
Potsdam Institute for Climate Impact Research;

/persons/resource/shafinaz

Sobhan,  Shafinaz
Potsdam Institute for Climate Impact Research;

Schmidt,  Wolf-Peter
External Organizations;

Nurul Huda,  Tarique Md.
External Organizations;

/persons/resource/waid

Waid,  Jillian Lee
Potsdam Institute for Climate Impact Research;

/persons/resource/Amanda.Wendt

Wendt,  Amanda
Potsdam Institute for Climate Impact Research;

Kader,  Abdul
External Organizations;

/persons/resource/gabrysch

Gabrysch,  Sabine
Potsdam Institute for Climate Impact Research;

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Citation

Lambrecht, N., Müller-Hauser, A., Sobhan, S., Schmidt, W.-P., Nurul Huda, T. M., Waid, J. L., Wendt, A., Kader, A., Gabrysch, S. (2023): Effect of a Homestead Food Production Program on the Prevalence of Diarrhea and Acute Respiratory Infection in Children in Sylhet, Bangladesh: A Cluster-Randomized Controlled Trial. - American Journal of Tropical Medicine and Hygiene, 109, 4, 945-956.
https://doi.org/10.4269/ajtmh.23-0152


Cite as: https://publications.pik-potsdam.de/pubman/item/item_28820
Abstract
Diarrhea and respiratory illness are leading causes of mortality and morbidity among young children. We assessed the impact of a homestead food production intervention on diarrhea and acute respiratory infection (ARI) in children in Bangladesh, secondary outcomes of the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial. The trial enrolled 2,705 married women and their children 3 years or younger in 96 rural settlements (geographic clusters) in Sylhet Division, Bangladesh. The intervention promoted home gardening and poultry rearing alongside child nutrition and health counseling over 3 years (2015–2018). An 8-month food hygiene behavior change component using emotional drivers was delivered beginning in mid-2017. Caregiver-reported diarrhea and symptoms of ARI in the week preceding the survey were recorded every 2 months. We analyzed 32,460 observations of 3,276 children over 4 years and found that 3.9% of children had diarrhea and 3.4% had an ARI in the prior 7 days. There was no overall effect of the intervention on 7-day diarrhea period prevalence (odds ratio [OR], 0.92; 95% CI, 0.71–1.19), diarrhea point prevalence (OR, 1.03; 95% CI, 0.78–1.36), or 7-day ARI period prevalence (OR, 1.18; 95% CI, 0.88–1.60). There was no impact on diarrhea severity or differences in health-seeking behaviors. Our findings suggest that this homestead food production program was insufficient to reduce morbidity symptoms among children in a rural setting. More comprehensive water, sanitation, and hygiene measures, and behavioral recommendations may be needed to achieve impacts on child health.