A Controlled Trial to Reduce the Risk of Human Nipah Virus Exposure in Bangladesh
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Human Nipah virus (NiV) infection, often fatal in Bangladesh, is primarily transmitted by drinking raw date palm sap contaminated by Pteropus bats. We assessed the impact of a behavior change communication intervention on reducing consumption of potentially NiV-contaminated raw sap. During the 2012–2014 sap harvesting seasons, we implemented interventions in two areas and compared results with a control area. In one area, we disseminated a “do not drink raw sap” message and, in the other area, encouraged only drinking sap if it had been protected from bat contamination by a barrier (“only safe sap”). Post-intervention, 40% more respondents in both intervention areas reported knowing about a disease contracted through raw sap consumption compared with control. Reported raw sap consumption decreased in all areas. The reductions in the intervention areas were not significantly greater compared to the control. Respondents directly exposed to the “only safe sap” message were more likely to report consuming raw sap from a protected source than those with no exposure (25 vs. 15%, OR 2.0, 95% CI 1.5–2.6, P < 0.001). While the intervention increased knowledge in both intervention areas, the “only safe sap” intervention reduced exposure to potentially NiV-contaminated sap and should be considered for future dissemination.
KeywordsNipah virus Behavior change communication intervention Date palm sap Bangladesh
Support for this study was provided by FHI 360 with funds from USAID Cooperative Agreement GHN-A-00-09-00002-00; this study was made possible by the generous support of the American people through the United States Agency for International Development (USAID). icddr,b acknowledges with gratitude the commitment of FHI 360 to the Centre’s research efforts. icddr,b is thankful to the Governments of Bangladesh, Canada, Sweden and the UK for providing core/unrestricted support. We are grateful to all the study participants for their valuable time. We are thankful to the quantitative data collection team. We acknowledge the continuous support of Professor Marcel Tanner from Swiss Tropical and Public Health Institute.
Compliance with Ethical Standards
Conflict of interests
Authors have no conflict of interest.
Human and Animal Rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants included in the study. Human subject review committees at icddr,b and FHI 360 approved the study protocol. The study protocol was registered as a clinical trial on clinicaltrials.gov (NCT01811784).
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