This study will test if affordable air cleaning devices (box fans with a filter attached and/or ultraviolet light lamps) installed in classrooms can reduce the number of viral respiratory illnesses schoolchildren experience.
This cluster-randomized controlled trial in Bangladesh schools will examine whether low-cost air filtration and/or human-safe ultraviolet germicidal light interventions can reduce the incidence of schoolchildren's respiratory viral infections. The main study objectives are: 1. Pilot and optimize an intervention to filter classroom air. 2. Pilot and optimize an intervention to treat classroom air with ultraviolet light. 3. Assess the separate and combined effect of air filtration and ultraviolet light on the incidence of polymerase chain reaction (PCR) confirmed illness from respiratory viruses. Methods: The study will take place in 60 government primary schools in Dhaka, Bangladesh. Within each enrolled school, 5 classrooms of students in grades 3, 4 and 5 will be randomly assigned to receive: 1. Box fans with a filter attachment. 2. 220 nanometer (nm) wavelength ultraviolet light air cleaner lamps. 3. Both the box fans with a filter and the 220 nm ultraviolet lamps. 4. No device: a control group that receives no additional device ("standard of care"). Two classrooms within each school will be assigned as controls. Why does this matter?: Clarifying the impact of low-cost practical solutions could support the adoption of these strategies that could reduce influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in schools in order to reduce the burden of respiratory illness in these communities.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
20,000
Classrooms assigned to this arm will be equipped with 2 - 8 box fans each with a single minimum efficiency reporting value-14 (MERV-14) filter sufficient to increase effective air changes per hour to 12 based on the clean air delivery rate measured in cubic feet per minute of the box fan + filter \* 60 divided by the room volume.
Classrooms assigned to this arm will be equipped with one or two 222nm wavelength light ultraviolet germicidal irradiation lamp units (number of units per classroom based on room volume).
Classrooms assigned to this arm will be equipped with both box fans and UV germicidal irradiation lamp units.
Total number of symptomatic respiratory illness episodes due to either Influenza or SARS- CoV-2
Study personnel will visit each school twice weekly. They will identify any students within the study classrooms who were absent or who have symptoms consistent with the World Health Organization (WHO) definition of influenza like illness. For children who were absent or who have symptoms, study personnel will visit the child's home, and if the student's parent provides informed consent, collect more detailed information on signs and symptoms, and a throat swab from the child. The throat swab will be placed on viral transport media, placed on ice and transported to the One Health Laboratory at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). One aliquot from the specimen will be analyzed for Influenza A, Influenza B, and SARS-CoV-2. In the laboratory, nucleic acid in the throat swab specimen will be extracted and one-step real-time (RT)-PCR conducted to assess the presence of RNA from Influenza A, Influenza B or SARS-CoV-2.
Time frame: Over 40 weeks of observation
Total number of symptomatic influenza-like illness episodes
Study personnel will visit each school twice weekly. They will identify any students within the study classrooms who were absent or who have symptoms consistent with the WHO definition of influenza like illness.
Time frame: Over 40 weeks of observation
Total number of symptomatic influenza episodes
Study personnel will visit each school twice weekly. They will identify any students within the study classrooms who were absent or who have symptoms consistent with the WHO definition of influenza like illness. For children who were absent or who have symptoms, study personnel will visit the child's home, and if the student's parent provides informed consent, collect more detailed information on signs and symptoms, and a throat swab from the child. The throat swab will be placed on viral transport media, placed on ice and transported to the One Health Laboratory at icddr,b. One aliquot from the specimen will be analyzed for Influenza A or Influenza B. In the laboratory, nucleic acid in the throat swab specimen will be extracted and one-step real-time RT-PCR conducted to assess the presence of RNA from Influenza A or Influenza B.
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Time frame: Over 40 weeks of observation
Total number of symptomatic SARS-CoV2 episodes
Study personnel will visit each school twice weekly. They will identify any students within the study classrooms who were absent or who have symptoms consistent with the WHO definition of influenza like illness. For children who were absent or who have symptoms, study personnel will visit the child's home, and if the student's parent provides informed consent, collect more detailed information on signs and symptoms, and a throat swab from the child. The throat swab will be placed on viral transport media, placed on ice and transported to the One Health Laboratory at icddr,b. One aliquot from the specimen will be analyzed for SARS-CoV2. In the laboratory, nucleic acid in the throat swab specimen will be extracted and one-step real-time RT-PCR conducted to assess the presence of RNA from SARS-CoV2.
Time frame: Over 40 weeks of observation
Total number of student absentee episodes
Study personnel will visit each school twice weekly. They will identify any students within the study classrooms who were absent.
Time frame: Over 40 weeks of observation