改善复杂环境中的水质和食品安全的多部门干预措施的影响和可持续性:乌干达北部的一个集群随机对照试验
Ian G Moore1, Yanlin Ren1, Stacy Griswold1
1Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
The American journal of tropical medicine and hygiene
|August 7, 2025
概括
通过减少大肠杆菌污染,NIPP+干预改善了家庭用水质量,但这种效果是暂时的. 需要进一步的研究,以了解在人道主义环境中持续改善水质和采用技术.
科学领域:
- 公共卫生 公共卫生
- 营养科学 营养科学
- 环境健康 环境健康
背景情况:
- 漫长的人道主义环境往往缺乏公共服务,导致食物和水污染,这是营养不良的主要原因.
- 多部门,社区驱动的计划为解决这些复杂问题提供了潜在的协同方法.
研究的目的:
- 评估两个社会和行为改变干预措施 (NIPP和NIPP+) 在减少乌干达北部营养不良驱动因素方面的有效性.
- 为了比较核心营养干预 (NIPP) 与增强版 (NIPP+) 的影响,并增加了技术采用推动.
主要方法:
- 一个1:1:1集群随机对照试验在乌干达北部进行.
- 测量的主要结局包括水中的大肠杆菌和大肠杆菌总量,玉米亚拉托克辛和女性血清亚拉托克辛B1-lysine.
- 数据在基线,终线和干预后1年收集,以评估可持续性.
主要成果:
- 根据NIPP+的干预措施,家庭大肠杆菌水污染在终点线上显著降低 (RR = 0.76;95% CI = 0.59-0.97).
- 这种水质的改善在1年的随访中没有持续下去.
- 对于玉米 aflatoxins或血清 aflatoxin B1.1,没有观察到显著的干预效应.
结论:
- 虽然NIPP+干预措施在改善水质方面取得了短期成功,但没有实现持续的影响.
- 对行为变化和技术采用的结构性障碍,以及有限的市场参与,可能会阻碍长期的有效性.
- 未来的干预措施需要加强计划实施,加强技术获取和产品销售的市场联系.
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