A community-based cluster randomised trial of safe storage to reduce pesticide self-poisoning in rural Sri Lanka: study protocol
Identifieur interne : 006241 ( Main/Exploration ); précédent : 006240; suivant : 006242A community-based cluster randomised trial of safe storage to reduce pesticide self-poisoning in rural Sri Lanka: study protocol
Auteurs : Melissa Pearson [Royaume-Uni, Sri Lanka] ; Flemming Konradsen [Danemark, Sri Lanka] ; David Gunnell [Royaume-Uni, Sri Lanka] ; Andrew H. Dawson [Sri Lanka, Australie] ; Ravi Pieris [Sri Lanka] ; Manjula Weerasinghe [Sri Lanka] ; Duleeka W. Knipe [Sri Lanka] ; Shaluka Jayamanne [Sri Lanka] ; Chris Metcalfe [Royaume-Uni] ; Keith Hawton [Royaume-Uni] ; A Rajitha Wickramasinghe [Australie] ; W. Atapattu [Sri Lanka] ; Palitha Bandara [Sri Lanka] ; Dhammika De Silva [Sri Lanka] ; Asanga Ranasinghe [Sri Lanka] ; Fahim Mohamed [Sri Lanka] ; Nicholas A. Buckley [Sri Lanka, Australie] ; Indika Gawarammana [Sri Lanka] ; Michael Eddleston [Royaume-Uni, Sri Lanka]Source :
- BMC Public Health [ 1471-2458 ] ; 2011.
Abstract
The WHO recognises pesticide poisoning to be the single most important means of suicide globally. Pesticide self-poisoning is a major public health and clinical problem in rural Asia, where it has led to case fatality ratios 20-30 times higher than self-poisoning in the developed world. One approach to reducing access to pesticides is for households to store pesticides in lockable "safe-storage" containers. However, before this approach can be promoted, evidence is required on its effectiveness and safety.
A community-based cluster randomised controlled trial has been set up in 44,000 households in the North Central Province, Sri Lanka. A census is being performed, collecting baseline demographic data, socio-economic status, pesticide usage, self-harm and alcohol. Participating villages are then randomised and eligible households in the intervention arm given a lockable safe storage container for agrochemicals.
The primary outcome will be incidence of pesticide self-poisoning over three years amongst individuals aged 14 years and over. 217,944 person years of follow-up are required in each arm to detect a 33% reduction in pesticide self-poisoning with 80% power at the 5% significance level. Secondary outcomes will include the incidence of all pesticide poisoning and total self-harm.
This paper describes a large effectiveness study of a community intervention to reduce the burden of intentional poisoning in rural Sri Lanka. The study builds on a strong partnership between provincial health services, local and international researchers, and local communities. We discuss issues in relation to randomisation and contamination, engaging control villages, the intervention, and strategies to improve adherence.
The trial is registered on ClinicalTrials.gov ref:
Url:
DOI: 10.1186/1471-2458-11-879
PubMed: 22104027
PubMed Central: 3227631
Affiliations:
- Australie, Danemark, Royaume-Uni, Sri Lanka
- Angleterre, Hovedstaden, Nouvelle-Galles du Sud, Oxfordshire, Écosse
- Copenhague, Oxford, Sydney, Édimbourg
- Université d'Oxford, Université d'Édimbourg
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Le document en format XML
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Atapattu</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="Bandara, Palitha" sort="Bandara, Palitha" uniqKey="Bandara P" first="Palitha" last="Bandara">Palitha Bandara</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="De Silva, Dhammika" sort="De Silva, Dhammika" uniqKey="De Silva D" first="Dhammika" last="De Silva">Dhammika De Silva</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="Ranasinghe, Asanga" sort="Ranasinghe, Asanga" uniqKey="Ranasinghe A" first="Asanga" last="Ranasinghe">Asanga Ranasinghe</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="Mohamed, Fahim" sort="Mohamed, Fahim" uniqKey="Mohamed F" first="Fahim" last="Mohamed">Fahim Mohamed</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I9">Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Buckley, Nicholas A" sort="Buckley, Nicholas A" uniqKey="Buckley N" first="Nicholas A" last="Buckley">Nicholas A. Buckley</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I10">Professorial Medicine Unit, POW Clinical School, University of New South Wales, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Professorial Medicine Unit, POW Clinical School, University of New South Wales, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Gawarammana, Indika" sort="Gawarammana, Indika" uniqKey="Gawarammana I" first="Indika" last="Gawarammana">Indika Gawarammana</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I11">Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Eddleston, Michael" sort="Eddleston, Michael" uniqKey="Eddleston M" first="Michael" last="Eddleston">Michael Eddleston</name><affiliation wicri:level="4"><nlm:aff id="I1">Clinical Pharmacology Unit, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Pharmacology Unit, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ</wicri:regionArea><orgName type="university">Université d'Édimbourg</orgName><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, 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type="university">Université d'Édimbourg</orgName><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Konradsen, Flemming" sort="Konradsen, Flemming" uniqKey="Konradsen F" first="Flemming" last="Konradsen">Flemming Konradsen</name><affiliation wicri:level="3"><nlm:aff id="I2">Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Gunnell, David" sort="Gunnell, David" uniqKey="Gunnell D" first="David" last="Gunnell">David Gunnell</name><affiliation wicri:level="1"><nlm:aff id="I3">School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol</wicri:regionArea><wicri:noRegion>Bristol</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Dawson, Andrew H" sort="Dawson, Andrew H" uniqKey="Dawson A" first="Andrew H" last="Dawson">Andrew H. Dawson</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I5">Drug Health, Royal Prince Alfred Hospital, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Drug Health, Royal Prince Alfred Hospital, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Pieris, Ravi" sort="Pieris, Ravi" uniqKey="Pieris R" first="Ravi" last="Pieris">Ravi Pieris</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Weerasinghe, Manjula" sort="Weerasinghe, Manjula" uniqKey="Weerasinghe M" first="Manjula" last="Weerasinghe">Manjula Weerasinghe</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Knipe, Duleeka W" sort="Knipe, Duleeka W" uniqKey="Knipe D" first="Duleeka W" last="Knipe">Duleeka W. Knipe</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Jayamanne, Shaluka" sort="Jayamanne, Shaluka" uniqKey="Jayamanne S" first="Shaluka" last="Jayamanne">Shaluka Jayamanne</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I6">Faculty of Medicine, University of Kelanyia, Kelanyia, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Faculty of Medicine, University of Kelanyia, Kelanyia</wicri:regionArea><wicri:noRegion>Kelanyia</wicri:noRegion></affiliation></author><author><name sortKey="Metcalfe, Chris" sort="Metcalfe, Chris" uniqKey="Metcalfe C" first="Chris" last="Metcalfe">Chris Metcalfe</name><affiliation wicri:level="1"><nlm:aff id="I3">School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol</wicri:regionArea><wicri:noRegion>Bristol</wicri:noRegion></affiliation></author><author><name sortKey="Hawton, Keith" sort="Hawton, Keith" uniqKey="Hawton K" first="Keith" last="Hawton">Keith Hawton</name><affiliation wicri:level="4"><nlm:aff id="I7">Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Wickramasinghe, A Rajitha" sort="Wickramasinghe, A Rajitha" uniqKey="Wickramasinghe A" first="A Rajitha" last="Wickramasinghe">A Rajitha Wickramasinghe</name><affiliation wicri:level="3"><nlm:aff id="I5">Drug Health, Royal Prince Alfred Hospital, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Drug Health, Royal Prince Alfred Hospital, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Atapattu, W" sort="Atapattu, W" uniqKey="Atapattu W" first="W" last="Atapattu">W. Atapattu</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="Bandara, Palitha" sort="Bandara, Palitha" uniqKey="Bandara P" first="Palitha" last="Bandara">Palitha Bandara</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="De Silva, Dhammika" sort="De Silva, Dhammika" uniqKey="De Silva D" first="Dhammika" last="De Silva">Dhammika De Silva</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="Ranasinghe, Asanga" sort="Ranasinghe, Asanga" uniqKey="Ranasinghe A" first="Asanga" last="Ranasinghe">Asanga Ranasinghe</name><affiliation wicri:level="1"><nlm:aff id="I8">Provincial Department of Health Services, North Central Province, Anuradhapura, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Provincial Department of Health Services, North Central Province, Anuradhapura</wicri:regionArea><wicri:noRegion>Anuradhapura</wicri:noRegion></affiliation></author><author><name sortKey="Mohamed, Fahim" sort="Mohamed, Fahim" uniqKey="Mohamed F" first="Fahim" last="Mohamed">Fahim Mohamed</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I9">Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Buckley, Nicholas A" sort="Buckley, Nicholas A" uniqKey="Buckley N" first="Nicholas A" last="Buckley">Nicholas A. Buckley</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I10">Professorial Medicine Unit, POW Clinical School, University of New South Wales, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Professorial Medicine Unit, POW Clinical School, University of New South Wales, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Gawarammana, Indika" sort="Gawarammana, Indika" uniqKey="Gawarammana I" first="Indika" last="Gawarammana">Indika Gawarammana</name><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I11">Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author><author><name sortKey="Eddleston, Michael" sort="Eddleston, Michael" uniqKey="Eddleston M" first="Michael" last="Eddleston">Michael Eddleston</name><affiliation wicri:level="4"><nlm:aff id="I1">Clinical Pharmacology Unit, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Pharmacology Unit, University of Edinburgh, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ</wicri:regionArea><orgName type="university">Université d'Édimbourg</orgName><placeName><settlement type="city">Édimbourg</settlement><region type="country">Écosse</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka</nlm:aff><country xml:lang="fr">Sri Lanka</country><wicri:regionArea>South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya</wicri:regionArea><wicri:noRegion>Peradeniya</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The WHO recognises pesticide poisoning to be the single most important means of suicide globally. Pesticide self-poisoning is a major public health and clinical problem in rural Asia, where it has led to case fatality ratios 20-30 times higher than self-poisoning in the developed world. One approach to reducing access to pesticides is for households to store pesticides in lockable "safe-storage" containers. However, before this approach can be promoted, evidence is required on its effectiveness and safety.</p></sec><sec><title>Methods/Design</title><p>A community-based cluster randomised controlled trial has been set up in 44,000 households in the North Central Province, Sri Lanka. A census is being performed, collecting baseline demographic data, socio-economic status, pesticide usage, self-harm and alcohol. Participating villages are then randomised and eligible households in the intervention arm given a lockable safe storage container for agrochemicals.</p><p>The primary outcome will be incidence of pesticide self-poisoning over three years amongst individuals aged 14 years and over. 217,944 person years of follow-up are required in each arm to detect a 33% reduction in pesticide self-poisoning with 80% power at the 5% significance level. Secondary outcomes will include the incidence of all pesticide poisoning and total self-harm.</p></sec><sec><title>Discussion</title><p>This paper describes a large effectiveness study of a community intervention to reduce the burden of intentional poisoning in rural Sri Lanka. The study builds on a strong partnership between provincial health services, local and international researchers, and local communities. We discuss issues in relation to randomisation and contamination, engaging control villages, the intervention, and strategies to improve adherence.</p></sec><sec><title>Trial Registritation</title><p>The trial is registered on ClinicalTrials.gov ref: <ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov/ct2/show/NCT1146496">NCT1146496</ext-link> (<ext-link ext-link-type="uri" xlink:href="http://clinicaltrialsfeeds.org/clinical-trials/show/NCT01146496">http://clinicaltrialsfeeds.org/clinical-trials/show/NCT01146496</ext-link>).</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Phillips, Mr" uniqKey="Phillips M">MR Phillips</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wickramasinghe, K" uniqKey="Wickramasinghe K">K Wickramasinghe</name></author><author><name sortKey="Steele, P" uniqKey="Steele P">P Steele</name></author><author><name sortKey="Dawson, A" uniqKey="Dawson A">A Dawson</name></author><author><name sortKey="Dharmaratne, D" uniqKey="Dharmaratne D">D Dharmaratne</name></author><author><name sortKey="Gunawardena, A" uniqKey="Gunawardena A">A Gunawardena</name></author><author><name sortKey="Senarathna, L" uniqKey="Senarathna L">L Senarathna</name></author><author><name sortKey="Siva, D" uniqKey="Siva D">D Siva</name></author><author><name sortKey="Wijayaweera, K" uniqKey="Wijayaweera K">K Wijayaweera</name></author><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Konradsen, F" uniqKey="Konradsen F">F Konradsen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gunnell, D" uniqKey="Gunnell D">D Gunnell</name></author><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Phillips, Mr" uniqKey="Phillips M">MR 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Dawson</name></author><author><name sortKey="Konradsen, F" uniqKey="Konradsen F">F Konradsen</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Konradsen, F" uniqKey="Konradsen F">F Konradsen</name></author><author><name sortKey="Pieris, R" uniqKey="Pieris R">R Pieris</name></author><author><name sortKey="Weerasinghe, M" uniqKey="Weerasinghe M">M Weerasinghe</name></author><author><name sortKey="Van Der Hoek, W" uniqKey="Van Der Hoek W">W van der Hoek</name></author><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Dawson, Ah" uniqKey="Dawson A">AH Dawson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hawton, K" uniqKey="Hawton K">K Hawton</name></author><author><name sortKey="Ratnayeke, L" uniqKey="Ratnayeke L">L Ratnayeke</name></author><author><name sortKey="Simkin, S" uniqKey="Simkin S">S Simkin</name></author><author><name sortKey="Harriss, L" uniqKey="Harriss L">L Harriss</name></author><author><name sortKey="Scott, V" uniqKey="Scott V">V Scott</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Weerasinghe, M" uniqKey="Weerasinghe M">M Weerasinghe</name></author><author><name sortKey="Pieris, R" uniqKey="Pieris R">R Pieris</name></author><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Hoek, W" uniqKey="Hoek W">W Hoek</name></author><author><name sortKey="Dawson, A" uniqKey="Dawson A">A Dawson</name></author><author><name sortKey="Konradsen, F" uniqKey="Konradsen F">F Konradsen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Konradsen, F" uniqKey="Konradsen F">F Konradsen</name></author><author><name sortKey="Dawson, Ah" uniqKey="Dawson A">AH Dawson</name></author><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Gunnell, D" uniqKey="Gunnell D">D Gunnell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eddleston, M" uniqKey="Eddleston M">M Eddleston</name></author><author><name sortKey="Udayakumara, N" uniqKey="Udayakumara N">N Udayakumara</name></author><author><name sortKey="Adhikari, S" uniqKey="Adhikari S">S Adhikari</name></author><author><name sortKey="De Silva, D" uniqKey="De Silva D">D De Silva</name></author><author><name sortKey="Sheriff, Mhr" uniqKey="Sheriff M">MHR Sheriff</name></author><author><name sortKey="Waidyaratne, Dl" uniqKey="Waidyaratne D">DL Waidyaratne</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Senarathna, L" uniqKey="Senarathna L">L Senarathna</name></author><author><name sortKey="Dibley, Mj" uniqKey="Dibley M">MJ Dibley</name></author><author><name sortKey="Dawson, A" uniqKey="Dawson A">A Dawson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Der Hoek, W" uniqKey="Van Der Hoek W">W Van der Hoek</name></author><author><name sortKey="Konradsen, F" uniqKey="Konradsen F">F Konradsen</name></author><author><name sortKey="Athukorala, K" uniqKey="Athukorala K">K Athukorala</name></author><author><name sortKey="Wanigadewa, T" uniqKey="Wanigadewa T">T Wanigadewa</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li><li>Danemark</li><li>Royaume-Uni</li><li>Sri Lanka</li></country><region><li>Angleterre</li><li>Hovedstaden</li><li>Nouvelle-Galles du Sud</li><li>Oxfordshire</li><li>Écosse</li></region><settlement><li>Copenhague</li><li>Oxford</li><li>Sydney</li><li>Édimbourg</li></settlement><orgName><li>Université d'Oxford</li><li>Université d'Édimbourg</li></orgName></list><tree><country name="Royaume-Uni"><region name="Écosse"><name sortKey="Pearson, Melissa" sort="Pearson, Melissa" uniqKey="Pearson M" first="Melissa" last="Pearson">Melissa Pearson</name></region><name sortKey="Eddleston, Michael" sort="Eddleston, Michael" uniqKey="Eddleston M" first="Michael" last="Eddleston">Michael Eddleston</name><name sortKey="Gunnell, David" sort="Gunnell, David" uniqKey="Gunnell D" first="David" last="Gunnell">David Gunnell</name><name sortKey="Hawton, Keith" sort="Hawton, Keith" uniqKey="Hawton K" first="Keith" last="Hawton">Keith Hawton</name><name sortKey="Metcalfe, Chris" sort="Metcalfe, Chris" uniqKey="Metcalfe C" first="Chris" last="Metcalfe">Chris Metcalfe</name></country><country name="Sri Lanka"><noRegion><name sortKey="Pearson, Melissa" sort="Pearson, Melissa" uniqKey="Pearson M" first="Melissa" last="Pearson">Melissa Pearson</name></noRegion><name sortKey="Atapattu, W" sort="Atapattu, W" uniqKey="Atapattu W" first="W" last="Atapattu">W. Atapattu</name><name sortKey="Bandara, Palitha" sort="Bandara, Palitha" uniqKey="Bandara P" first="Palitha" last="Bandara">Palitha Bandara</name><name sortKey="Buckley, Nicholas A" sort="Buckley, Nicholas A" uniqKey="Buckley N" first="Nicholas A" last="Buckley">Nicholas A. Buckley</name><name sortKey="Dawson, Andrew H" sort="Dawson, Andrew H" uniqKey="Dawson A" first="Andrew H" last="Dawson">Andrew H. Dawson</name><name sortKey="De Silva, Dhammika" sort="De Silva, Dhammika" uniqKey="De Silva D" first="Dhammika" last="De Silva">Dhammika De Silva</name><name sortKey="Eddleston, Michael" sort="Eddleston, Michael" uniqKey="Eddleston M" first="Michael" last="Eddleston">Michael Eddleston</name><name sortKey="Gawarammana, Indika" sort="Gawarammana, Indika" uniqKey="Gawarammana I" first="Indika" last="Gawarammana">Indika Gawarammana</name><name sortKey="Gawarammana, Indika" sort="Gawarammana, Indika" uniqKey="Gawarammana I" first="Indika" last="Gawarammana">Indika Gawarammana</name><name sortKey="Gunnell, David" sort="Gunnell, David" uniqKey="Gunnell D" first="David" last="Gunnell">David Gunnell</name><name sortKey="Jayamanne, Shaluka" sort="Jayamanne, Shaluka" uniqKey="Jayamanne S" first="Shaluka" last="Jayamanne">Shaluka Jayamanne</name><name sortKey="Jayamanne, Shaluka" sort="Jayamanne, Shaluka" uniqKey="Jayamanne S" first="Shaluka" last="Jayamanne">Shaluka Jayamanne</name><name sortKey="Knipe, Duleeka W" sort="Knipe, Duleeka W" uniqKey="Knipe D" first="Duleeka W" last="Knipe">Duleeka W. Knipe</name><name sortKey="Konradsen, Flemming" sort="Konradsen, Flemming" uniqKey="Konradsen F" first="Flemming" last="Konradsen">Flemming Konradsen</name><name sortKey="Mohamed, Fahim" sort="Mohamed, Fahim" uniqKey="Mohamed F" first="Fahim" last="Mohamed">Fahim Mohamed</name><name sortKey="Mohamed, Fahim" sort="Mohamed, Fahim" uniqKey="Mohamed F" first="Fahim" last="Mohamed">Fahim Mohamed</name><name sortKey="Pieris, Ravi" sort="Pieris, Ravi" uniqKey="Pieris R" first="Ravi" last="Pieris">Ravi Pieris</name><name sortKey="Ranasinghe, Asanga" sort="Ranasinghe, Asanga" uniqKey="Ranasinghe A" first="Asanga" last="Ranasinghe">Asanga Ranasinghe</name><name sortKey="Weerasinghe, Manjula" sort="Weerasinghe, Manjula" uniqKey="Weerasinghe M" first="Manjula" last="Weerasinghe">Manjula Weerasinghe</name></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Konradsen, Flemming" sort="Konradsen, Flemming" uniqKey="Konradsen F" first="Flemming" last="Konradsen">Flemming Konradsen</name></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Dawson, Andrew H" sort="Dawson, Andrew H" uniqKey="Dawson A" first="Andrew H" last="Dawson">Andrew H. Dawson</name></region><name sortKey="Buckley, Nicholas A" sort="Buckley, Nicholas A" uniqKey="Buckley N" first="Nicholas A" last="Buckley">Nicholas A. Buckley</name><name sortKey="Wickramasinghe, A Rajitha" sort="Wickramasinghe, A Rajitha" uniqKey="Wickramasinghe A" first="A Rajitha" last="Wickramasinghe">A Rajitha Wickramasinghe</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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