TY  - JOUR
PY  - 2011//
TI  - A community-based cluster randomised trial of safe storage to reduce pesticide self-poisoning in rural Sri Lanka: Study protocol
JO  - BMC public health
A1  - Pearson, Melissa
A1  - Konradsen, Flemming
A1  - Gunnell, David
A1  - Dawson, Andrew H.
A1  - Peiris, Ravi
A1  - Weerasinghe, Manjula
A1  - Knipe, Duleeka W.
A1  - Jayamanne, Shaluka
A1  - Metcalfe, Chris
A1  - Hawton, Keith E.
A1  - Wickramasinge, A. Rajitha
A1  - Atapattu, W.
A1  - Bandara, Palitha
A1  - de Silva, Dhammika
A1  - Ranasinghe, Asanga
A1  - Mohamed, Fahim
A1  - Buckley, Nicholas A.
A1  - Gawarammana, Indika
A1  - Eddleston, Michael
SP  - 879
EP  - 879
VL  - 11
IS  - 1
N2  - BACKGROUND: 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. METHODS: 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. DISCUSSION: 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: NCT1146496 (http://clinicaltrialsfeeds.org/clinical-trials/show/NCT01146496).<p />  <p>Language: en</p>
LA  - en
SN  - 1471-2458
UR  - http://dx.doi.org/10.1186/1471-2458-11-879
ID  - ref1
ER  -