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Earthen floors are often damp or dusty and difficult to clean, providing an ideal environment for faecal pathogens and parasites. Observational studies have revealed associations between household flooring and health outcomes, but robust experimental evidence is scant. This study will evaluate the impact of an improved household flooring intervention on enteric infections, soil-transmitted helminth (STH) infections and tungiasis through implementation of a cluster-randomised trial in two rural settings in Kwale and Bungoma Counties, Kenya.
440 clusters (households) across both sites are allocated to control or intervention group, in which a low-cost, sealed, washable, cement-based floor is installed in eligible buildings of the dwelling, alongside a floor-care guide provided during an induction meeting. Following baseline assessments in both groups, all individuals over 1 year receive albendazole and those infected with tungiasis receive benzyl benzoate. Primary outcomes are as follows: prevalence of enteric infections in children under 5 years assessed via stool surveys and PCR; prevalence of tungiasis infection in children 1–14 years based on clinical exam; and prevalence of STH infection in all household members over 1 year assessed via Kato-Katz. Secondary outcomes include the following: intensity of STH and tungiasis infections; prevalence of caregiver-reported gastrointestinal illness in children under 5; quality of life and well-being measures; and environmental contamination. A process evaluation investigates intervention acceptability, durability, practicality and cost.
The protocol has been approved by ethics committees of The Kenya Medical Research Institute, The Kenya National Commission for Science Technology and Innovation, and The London School of Hygiene & Tropical Medicine. Following the 12-month implementation period and final assessments, control households are offered improved floors. Results will be disseminated within Kenya, to the Ministries of Health and of Lands, Public Works, Housing and Urban Development, and to subnational leadership and communities. Dissemination will also occur through publications and conference presentations.
Preventing pressure injuries is a primary objective for care and treatment teams in intensive care units (ICUs). Therefore, the current study aimed to compare the efficacy of Zinc Oxide and Vaseline prophylactic dressings in preventing sacral pressure injuries in patients admitted to the ICU. This clinical trial was conducted in the ICU in 2023. The study population included patients at moderate to high risk for pressure injuries based on the Braden scale criteria. Eligible patients were randomly assigned to one of five groups using random allocation software: (1) the intervention group receiving Zinc Oxide as a prophylactic dressing, (2) the intervention group using Zinc Oxide as a topical application, (3) the intervention group with Vaseline as a prophylactic dressing, (4) the intervention group using Vaseline as a topical application and (5) the control group. Participants were homogenous regarding demographic information in all five groups. The frequency distribution of pressure injuries across the five groups was analysed using the Chi-square test. The results revealed no pressure injuries were observed in the Zinc Oxide and Vaseline with dressing groups. In contrast, the Zinc Oxide without dressing group had five cases, the Vaseline without dressing group had six cases and the Control group had 14 cases of pressure injuries. These differences were statistically significant (p < 0.05). The results of this study showed that Zinc Oxide and Vaseline as preventive dressings in the sacral area of patients admitted to ICUs can be considered an effective and affordable strategy for healthcare providers.
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