The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial: Rationale, Design, and Methods
The SHINE trial is a multi-partner research project that explores: (1) environmental enteric dysfunction (EED) in stunting and anemia; (2) whether and how chronic inflammation in EED is implicated in adverse nutrition outcomes; and (3) the extent to which EED is caused by fecal ingestion due to poor water, sanitation, and hygiene (WASH) conditions. The trial is being conducted in 2 rural districts of Zimbabwe, and will monitor length and hemoglobin for children at 18 months of age in relation to independent and combined effects of fecal ingestion and nutritional adequacy.
This article describes the rationale, design, and methods underlying the SHINE trial, and is part of a series that includes (e.g.) the summary of an intervention that aims to minimize ingestion of fecal microbes using TIPS methodology (Trials of Improved Practices).