Kristen Heitzinger, MPH
Nominated From: University of Washington
Research Site: Peru
Project: Diarrhea Prevention and Treatment
Primary Mentor: Joseph Zunt, M.D., M.P.H; University of Washington
Research Project Background
Diarrheal disease is the second leading cause of mortality among children under five and may be an even greater cause of morbidity. Due to resulting impairments in physical and cognitive function (1, 2).Although diarrhea is easily prevented and treated with low-cost interventions including household water treatment and oral rehydration solution, scale-up of these interventions globally and in Peru has not progressed in recent years (3-5); this has been attributed to a lack of formative research to improve intervention delivery strategies, particularly in poor populations where health benefits can be maximized (4, 6, 7). The Loreto region of the
Peruvian Amazon has the highest rate of childhood diarrhea in the country and a 26% prevalence of diarrhea in children under five (5). In the Peruvian Amazon, 87% of households of children under age 5 drink from microbiologically contaminated sources (8), yet only an estimated 19% of households treat their water to make it safe to drink (5)* and only 30% of diarrheic children receive potentially life-saving oral rehydration solution (5). To develop effective delivery strategies for the prevention and management of childhood diarrheal disease in the Peruvian Amazon, we propose the following aims.
1) Use mixed qualitative and quantitative methods to investigate barriers and motivating factors that influence uptake and sustained use of household water treatment. A secondary aim will be to identify community agents to effectively deliver a pilot behavior change intervention.
2) Use mixed qualitative and quantitative methods to investigate determinants of appropriate diarrhea case management including oral rehydration solution with zinc supplementation and continued feeding.
3) Assess the acceptability of a pilot behavioral intervention to promote household water treatment, with specific messages determined using Objective 1 results. Secondary objectives will be to evaluate the effectiveness of the intervention in motivating household water treatment uptake and sustained use.