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Journal Article

Effect of a behavior change intervention on complementary food contamination in rural Bangladesh: a cluster-randomized controlled trial

Authors

Huda,  Tarique
External Organizations;

/persons/resource/anna.mueller

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

/persons/resource/shafinaz

Sobhan,  Shafinaz
Potsdam Institute for Climate Impact Research;

Hossen,  Saheen
External Organizations;

Sultana,  Jesmin
External Organizations;

Rahman,  Mahbubur
External Organizations;

Gautam,  Om Prasad
External Organizations;

/persons/resource/Amanda.Wendt

Wendt,  Amanda
Potsdam Institute for Climate Impact Research;

/persons/resource/waid

Waid,  Jillian Lee
Potsdam Institute for Climate Impact Research;

/persons/resource/gabrysch

Gabrysch,  Sabine
Potsdam Institute for Climate Impact Research;

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Citation

Huda, T., Müller-Hauser, A., Sobhan, S., Hossen, S., Sultana, J., Rahman, M., Gautam, O. P., Wendt, A., Waid, J. L., Gabrysch, S. (in press): Effect of a behavior change intervention on complementary food contamination in rural Bangladesh: a cluster-randomized controlled trial. - American Journal of Tropical Medicine and Hygiene.


Cite as: https://publications.pik-potsdam.de/pubman/item/item_30780
Abstract
Children in low-resource settings often consume microbially contaminated food, risking their health. We evaluated the impact of a food hygiene intervention on complementary food contamination in Bangladesh. A three-year homestead food production intervention was complemented by an eight-month behavior change module to improve household food hygiene practices and evaluated in a cluster-randomized controlled trial including a dedicated study measuring outcomes along the hygiene pathway to intestinal health. In this analysis, we used multilevel regression to assess the intervention's impact on microbial food contamination, as well as on food hygiene knowledge (n=518) and reported practices (n=531) among mothers of children aged 6-23 months. Complementary food samples were collected from 342 households with children aged 6-18 months and tested for Escherichia coli. Overall, 46% of food samples were contaminated with Escherichia coli (42% intervention, 49% control), and there was no evidence that the intervention reduced food contamination (Odds Ratio: 0.7, 95% CI: 0.3-1.2, p=0.18). A higher proportion of intervention mothers could name all key food hygiene practices (22% intervention vs. 0% control), had access to a basic handwashing station near the kitchen (24% vs. 14%, p=0.03), reported washing hands before food preparation and child feeding (21% vs. 8%, p=0.001), washing and storing feeding utensils safely (61% vs. 49%, p=0.02), and preparing food fresh or reheating stored food (88% vs. 79%, p=0.03), compared to control mothers. The intervention thus improved knowledge and reported food hygiene practices among mothers, but this improvement did not result in a substantial reduction of complementary food contamination