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The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial: Rationale, Design, and Methods

The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial centers around the premise that environmental enteric dysfunction (EED) is a main underlying cause of child stunting and anemia, largely attributable to chronic inflammation, and is primarily caused by the ingestion of fecal matter due to poor water, sanitation, and hygiene (WASH). The trial is investigating the effects of a WASH intervention and an infant and young child feeding (IYCF) intervention, measured by child length and hemoglobin status at 18 months of age, among other biomarkers. Two causal pathways will be analyzed: the program impact pathway and the biomedical pathway. This article discusses the rationale, design, and methods of the trial.

Clinical Infectious Diseases. 2015