Randomised Controlled Trails - Essay Example

Randomised Controlled Trails A). Comment on the strengths and weaknesses of the outcome measures that were used in the study. You are expected to justify your answers. The outcome of the study on assessing water filtration and safe storage in households with young children of HIV-positive mothers had the following strengths and weaknesses. The outcome measures in question are: the use, water quality, diarrhea longitudinal prevalence, and weight-for-age z-scores (WAZ). The use The use was an outcome measure in which the researchers investigated the respondents’ filter use and acceptability. The following measure had both strengths and weaknesses. Firstly, the households that contained functional filters were the only ones used in the study. This gave the study a chance to obtain valid results because the filters in use provided a long term analysis of water treatment. Secondly, there was exclusive use of filtered water as respondents were cautioned against drinking unfiltered water in the day or the day before the interview (Peletz et al., 2012). The following step ensured that only the data from the analysis of the filtered water was tested making results more reliable. On the other hand, the following outcome measure had its own weaknesses. Firstly, the filter was observed in the household at the time of visit. The research team could not establish whether the filter had been in use, or it was fitted for the purpose of the study. Secondly, the result outcomes were liable to distortion, especially when the respondents were told not to take any unfiltered water. In case the respondent walked away from home, there was no clarification on the type of water used, especially in hotels and social areas. Water quality The research team collected water samples during monthly visits while taking samples from the vessels that the respondent used to store drinking water in. The research team also used control households that only used water that was collected. The use of control households increased the strength of the study because the research team had a base to make comparisons. In addition, the research used both filtered and unfiltered water for sample analysis. The filtered water was tested immediately after filtration that minimized chances of contamination. Secondly, water samples were collected in a clean sterile whirl-Pak bag with tablets of sodium thiosulfate to neutralize any disinfectant. The process ensured only clean and uncontaminated water was used throughout the research. The following outcome still had some weaknesses. Firstly, the research team did not investigate the storage vessels for the presence of any contaminants. Secondly, the microbiological membrane filtration method used had the possibility of failing because the DelAgua field incubator could get damaged by high temperatures bearing in mind Zambia is near a desert. The destruction of the incubator could lead to invalid results. For instance, it could be the main reason why the intervened households recorded better water quality than the control groups (Peletz et al., 2012). Diarrhea longitudinal prevalence The diarrhea longitudinal prevalence acted as a way of determining the mother’s infections in the past. The following outcome measure was significance in the study because it strengthened the reliability of research methodology by ensuring the respondents provide correct information. In addition, the diarrhea experience for the last seven days was measured. This was also strength because it acted as a measure of possibility of the mother having the diarrhea case at the time of study. The main weakness of the outcome measure was the lack of truth from the information acquired from the mothers. Only 13.6% of the respondents were reported to have diarrhea cases in the control arm while 6.6% reported in the intervention arm (Peletz et al 2012). The following results had some biases because it was expected that more mothers could report positive to diarrhea prevalence. Weight-for-Age Z-scores (WAZ) This method had a single strength. By taking the weight of children, the research team could easily monitor the child’s improvement since weight is directly proportional to growth for young children. Moreover, weight was measured twice per every visit leaving no room for errors. On the other hand, the outcome had a weakness. The use of weight as a variable in the research could have introduced other factors like the child nutrition. The study only concentrated on water filtration and safe storage, whose impact on weight is minimal. B). Comment on the main results of the study by peletz et al and how can you ensure that any decision for the widespread introduction of water filtration in reducing deaths due to enteric infection in young children of HIV-positive mothers is appropriate for the local context for which the public health department has responsibility. You are expected to justify your answers. The main results from the study indicated a high level use of filters in household water storage. According to Peletz et al. (2012), 96% of the households met the desired criteria. The results indicated that the HIV campaigners had done a perfect job in educating the victims on the dangers posed by using untreated water. Moreover, the results were ranked in term of demographics, socioeconomic quintiles, water source, hygiene practices, and water quality. The results also showed that the quality of water stored in households where the intervention occurred was better than in control households. This intervention had a high recommendation because it captures all the factors that influence the quality of water used by people. On the other hand, results also indicated that the selected households maintained high hygiene in order to protect their children from being affected by diseases, creating a high level of responsibility. The results indicated that the intervened households either maintained high level of hygiene, or they acted in a manner to please the researchers. Moreover, it indicated the lack of preparedness by the researchers in selecting the type of data to collect and which target group to focus on. Recommendations In ensuring the widespread use of water filtration to reduce deaths due to enteric infections among these children, the research should have adopted the following method. The research team should have carried out a nationwide campaign on the importance of water filtration not only to the HIV positive people but also to the rest of the population. Moreover, the government should set aside funds for conducting training to HIV-infected mothers on how to maintain proper hygiene for their families. Secondly, the government through the ministries of public health should ensure all HIV-positive victims have access to reliable health services irrespective of the level of income and distance from the major towns. One of the weaknesses of the study outcome was the lack of information from people who had no access to healthcare services because of one reason or another. Reference Peletz R, Simunyama M, Sarenje K, Baisley K, Filteau S, et al. (2012). Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia. PLoS ONE 7(10): e46548. doi:10.1371/journal.pone.0046548 Read More