[Accepted Manuscript] Use, microbiological effectiveness and health impact of a household water filter intervention in rural Rwanda-A matched cohort study.


Kirby, M.A.; Nagel, C.L.; Rosa, G.; Umupfasoni, M.M.; Iyakaremye, L.; Thomas, E.A.; Clasen, T.F.; (2017) [Accepted Manuscript] Use, microbiological effectiveness and health impact of a household water filter intervention in rural Rwanda-A matched cohort study. International journal of hygiene and environmental health. ISSN 1438-4639 DOI: https://doi.org/10.1016/j.ijheh.2017.05.013

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Abstract

Unsafe drinking water is a substantial health risk contributing to child diarrhoea. We investigated impacts of a program that provided a water filter to households in rural Rwandan villages. We assessed drinking water quality and reported diarrhoea 12-24 months after intervention delivery among 269 households in the poorest tertile with a child under 5 from 9 intervention villages and 9 matched control villages. We also documented filter coverage and use. In Round 1 (12-18 months after delivery), 97.4% of intervention households reported receiving the filter, 84.5% were working, and 86.0% of working filters contained water. Sensors confirmed half of households with working filters filled them at least once every other day on average. Coverage and usage was similar in Round 2 (19-24 months after delivery). The odds of detecting faecal indicator bacteria in drinking water were 78% lower in the intervention arm than the control arm (odds ratio (OR) 0.22, 95% credible interval (CrI) 0.10-0.39, p<0.001). The intervention arm also had 50% lower odds of reported diarrhoea among children <5 than the control arm (OR=0.50, 95% CrI 0.23-0.90, p=0.03). The protective effect of the filter is also suggested by reduced odds of reported diarrhoea-related visits to community health workers or clinics, although these did not reach statistical significance.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
URI: http://researchonline.lshtm.ac.uk/id/eprint/3962319

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