Evidence Based Targeted Water Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo

What this Trial Is About

Researchers are evaluating a targeted water, sanitation, and hygiene (WASH) intervention to reduce cholera and severe diarrhea among household members of diarrhea patients in South Kivu, Democratic Republic of the Congo. The study includes formative research and a randomized controlled trial to assess how effective the intervention is at lowering diarrheal diseases and improving WASH behaviors within these households. It also investigates transmission dynamics of cholera and severe diarrhea using genomics and risk factor analysis. The study has two phases: first, developing the WASH intervention through research and community engagement; second, implementing and evaluating it in a randomized trial. In the trial, households are assigned to either the PICHA7 mHealth program or the standard message given in DRC health facilities. The PICHA7 program includes an in-person delivery of a pictorial WASH module by a health promoter, two home visits during the 7-day high-risk period, and a diarrhea prevention package with chlorine tablets, soapy water, a handwashing station, and a water vessel with lid and tap. Afterward, households receive weekly voice and text messages for 12 months promoting recommended WASH behaviors. Participants include diarrhea patients and their household members who will be followed for 12 months. Researchers will assess diarrhea occurrences among household members as the primary outcome. Secondary measures include child development, handwashing behaviors, water quality, presence of bacteria in stored water, psychosocial factors related to WASH, and growth measurements in children under 5 years. Data collection occurs at multiple time points up to 24 months. The study will monitor adherence to interventions and evaluate the impact on diarrheal disease transmission within households.

Preventative Intervention for Cholera for 7 Days