Abstract：
(a) Objective: To build an evidence base on effective water, sanitation, and hygiene interventions to reduce diarrheal diseases in cholera hotspots, we developed the CHoBI7 Cholera Rapid Response Program. (b) Methods: Once a cholera patient (confirmed by bacterial culture) is identified at a health facility, a health promoter delivers a targeted WASH intervention to the cholera hotspot (households within 20 m of a cholera patient) through both in-person visits during the first week and bi-weekly WASH mobile messages for the 3-month program period. A randomized controlled trial of the CHoBI7 Cholera Rapid Response Program was conducted with 284 participants in 15 cholera hotspots around cholera patients in urban Dhaka, Bangladesh. This program was compared to the standard message in Bangladesh on the use of oral rehydration solution for dehydration. Five-hour structured observation of handwashing with soap and diarrhea surveillance was conducted monthly. (c) Findings: Handwashing with soap at food- and stool-related events was significantly higher in the CHoBI7 Cholera Rapid Response Program arm compared to the standard message arm at all timepoints (overall 54% in the CHoBI7 arm vs. 23% in the standard arm, p < 0.05). Furthermore, there was a significant reduction in diarrheal prevalence for all participants (adults and children) (Prevalence Ratio (PR) 0.35, 95% CI: 0.14-0.85) and for children under 5 years of age (PR: 0.27, 95% CI: 0.085-0.87) during the 3-month program. (d) Conclusions: These findings demonstrate that the CHoBI7 Cholera Rapid Response Program is effective in lowering diarrhea prevalence and increasing handwashing with soap for a population at high risk of cholera.
摘要：
(a)目标：建立有效水的证据基础，卫生，和卫生干预措施，以减少霍乱热点地区的腹泻疾病，我们开发了CHoBI7霍乱快速反应计划。（b）方法：一旦在医疗机构确定了霍乱患者（通过细菌培养确认），健康促进者通过第一周的当面访视和为期3个月的计划期间的每两周一次的WASH移动消息,向霍乱热点(霍乱患者20米以内的家庭)提供有针对性的WASH干预。一项关于CHoBI7霍乱快速反应计划的随机对照试验是在达卡市区霍乱患者周围的15个霍乱热点地区的284名参与者进行的，孟加拉国。将该程序与孟加拉国使用口服补液脱水的标准信息进行了比较。每月进行5小时的肥皂洗手观察和腹泻监测。（c）结果：在所有时间点，与标准信息组相比，CHoBI7霍乱快速反应计划组在食物和粪便相关事件中用肥皂洗手的比例明显更高（CHoBI7组总体上为54％23%在标准臂中，p<0.05)。此外，所有参与者(成人和儿童)(患病率比(PR)0.35,95%CI:0.14~0.85)和5岁以下儿童(PR:0.27,95%CI:0.085~0.87)在3个月计划期间腹泻患病率均显著降低.（d）结论：这些发现表明，CHoBI7霍乱快速反应计划可有效降低霍乱高危人群的腹泻患病率并增加用肥皂洗手。
