24 months post intervention

Stool samples were tested for a range of pathogens, including nine bacteria, three protozoa, and three viruses.

At the baseline, 78% of children with available stool samples had more than one bacterial or protozoan infection, while 45% had multiple instances of soil-transmitted helminths (STH). The prevalence of these infections was similar in both the intervention and control groups at the start of the study.

Interestingly, the prevalence of most bacterial, protozoan, and STH infections increased with age, while enteric viral infections decreased as children got older.

In the control group, the 24-month results showed that the intervention did not significantly reduce the prevalence of any bacterial or protozoan infections, STH re-infections, or diarrhoea at 24 months. There was also limited evidence that the intervention impacted the prevalence of any pathogen type or co-infections with two or more types of pathogens.

An addition to the control-group study, a subgroup analysis was conducted to explore the impact of the intervention on children who were born after the baseline but before the 24-month follow-up. This analysis compared them to children who were two years old or younger at the baseline. By doing so, scientists could investigate whether being exposed to the intervention from birth would reduce the risk of enteric pathogen infections during the first two years of life.

In the subgroup analysis of children born into the study sites after the intervention was implemented, results were more promising. When compared to children under two years old at baseline, those born after the intervention showed a 48% reduction in the prevalence of any STH, a 76% reduction in Trichuris, and a 51% reduction in Shigella infections. These effects were less pronounced among older children (those over 2 years old) who were born before the intervention and present at the 24-month phase.

The study revealed that being born into an intervention site, where sanitation improvements were in place from birth, helped delay exposure to harmful pathogens and reduced the accumulation of infections in the first two years of life.