Anna Bowen|Mubina Agboatwalla|Stephen P. Luby|Timothy Tobery|Tracy Ayers|Robert M. Hoekstra
Association Between Intensive Handwashing Promotion and Child Development in Karachi, Pakistan
h3objectiveh3to evaluate associations handwashing promotion child growth developmenth3designh3cluster randomized controlled trialh3settingh3informal settlements karachi pakistanh3participantsh3a total 461 children enrolled trial householdlevel handwashing promotion 2003 younger 8 years reassessment 2009h3interventionsh3in 2003 neighborhoods randomized control n 9 handwashing promotion n 9 handwashing promotion drinking water treatment n 10 intervention households received free soap weekly handwashing promotion 9 monthsh3main outcome measuresh3anthropometrics developmental quotients measured battelle developmental inventory ii 5 7 years ageh3resultsh3overall 249 95 ci 200306 221 95 ci 180268 children z scores 2 sds expected z scores height body mass index age respectively anthropometrics differ significantly across study groups global developmental quotients averaged 1044 95 ci 10191070 among intervention children 983 95 ci 9311034 among control children p 04 differences similar magnitude measured across adaptive personalsocial communication cognitive motor domainsh3conclusionsh3although growth similar across groups children randomized handwashing promotion first 30 months age attained global developmental quotients 04 sds greater control children 5 7 years age gains comparable atrisk children enrolled publicly funded preschools united states suggest handwashing promotion could improve child wellbeing societal productivityh3trial registrationh3clinicaltrialsgov identifier nct01538953