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

Int J Hyg Environ Health. 2017 Aug;220(6):1020-1029. doi: 10.1016/j.ijheh.2017.05.013. Epub 2017 Jun 1.

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.

Keywords: Faecal contamination; Household water treatment; Rwanda; Water quality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bacteria / isolation & purification
  • Child, Preschool
  • Cohort Studies
  • Diarrhea / epidemiology*
  • Drinking Water / analysis
  • Drinking Water / microbiology*
  • Female
  • Filtration / methods*
  • Housing
  • Humans
  • Male
  • Odds Ratio
  • Rural Population
  • Rwanda / epidemiology
  • Water Microbiology
  • Water Purification / methods*
  • Water Quality

Substances

  • Drinking Water