Christine Marie George | Shirajum Monira | Fatema Zohura | Elizabeth D. Thomas | M. Tasdik Hasan | Tahmina Parvin | Khaled Hasan | Mahamud-Ur Rashid | Nowshin Papri | Aminul Islam | Zillur Rahman | Raisa Rafique | Sazzadul Islam Bhuyian | Ronald Saxton | Alain Labrique | Kelsey Alland | Indrajeet Barman | Fatema Tuz Jubyda | Farzana Afroze | Marzia Sultana | Fatema-Tuz Johura | Md Abul Hasem Khan | Sanya Tahmina | Farzana Munmun | David A. Sack | Jamie Perin | Munirul Alam
Date of Publication:
Aug 06, 2020
Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
The Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) mobile health (mHealth) program was a cluster-randomized controlled trial of diarrhea patient households conducted in Dhaka, Bangladesh.
Patients were block-randomized to three arms: standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. The primary outcome was reported diarrhea in the past two weeks collected monthly for 12 months. The secondary outcomes were stunting, underweight, and wasting at a 12 month follow-up. Analysis was intention-to-treat.
Between December 4, 2016 and April 26, 2018, 2626 participants in 769 households were randomly allocated to three arms: 849 participants to standard message, 886 to mHealth with no home visits, and 891 to mHealth with two home visits. Children under five years had significantly lower 12-month diarrhea prevalence in both the mHealth with two home visits arm (Prevalence Ratio(PR): 0.73 (95% Confidence Interval(CI): 0.61, 0.87)) and the mHealth with no home visits arm (PR: 0.82 (95% CI: 0.69, 0.97)). Children under 2 years were significantly less likely to be stunted in both the mHealth with two home visits arm (33% vs. 45%, Odds Ratio(OR): 0.55, 95% CI: 0.31, 0.97) and the mHealth with no home visits arm (32% vs. 45%, OR: 0.54, 95% CI: 0.31, 0.96) compared to children in the standard message arm.
Overall, the CHoBI7 mHealth program lowered pediatric diarrhea and stunting among diarrhea patient households.