A Randomized Controlled Trial to Assess the Impact of Ceramic Water Filters on Prevention of Diarrhea and Cryptosporidiosis in Infants and Young Children—Western Kenya, 2013

Abstract

is a leading cause of diarrhea among Kenyan infants. Ceramic water filters (CWFs) are used for household water treatment. We assessed the impact of CWFs on diarrhea, cryptosporidiosis prevention, and water quality in rural western Kenya. A randomized, controlled intervention trial was conducted in 240 households with infants 4-10 months old. Twenty-six weekly household surveys assessed infant diarrhea and health facility visits. Stool specimens from infants with diarrhea were examined for . Source water, filtered water, and filter retentate were tested for and/or microbial indicators. To estimate the effect of CWFs on health outcomes, logistic regression models using generalized estimating equations were performed; odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Households reported using surface water (36%), public taps (29%), or rainwater (17%) as their primary drinking water sources, with no differences in treatment groups. Intervention households reported less diarrhea (7.6% versus 8.9%; OR: 0.86 [0.64-1.16]) and significantly fewer health facility visits for diarrhea (1.0% versus 1.9%; OR: 0.50 [0.30-0.83]). In total, 15% of intervention and 12% of control stools yielded ( = 0.26). was detected in 93% of source water samples; 71% of filtered water samples met World Health Organization recommendations of< 1 /100 mL. was not detected in source water and was detected in just 2% of filter rinses following passage of large volumes of source water. Water quality was improved among CWF users; however, the short study duration and small sample size limited our ability to observe reductions in cryptosporidiosis.

From Water Source to Tap of Ceramic Filters—Factors That Influence Water Quality Between Collection and Consumption in Rural Households in Nepal

“…Previous studies have documented the significant impact ceramic water filter interventions had on improving drinking water quality and, subsequently, reducing health risks [ 15 , 16 , 17 , 19 , 20 , 29 ]. However, contrary to our expectations, this intervention did not achieve a satisfactory improvement in drinking water quality at the point of consumption.…”

“…Several studies have documented the successful impact of ceramic water filters on improving drinking water quality at the point of consumption in the field context [ 15 ], including a reduction of diarrhea in communities using ceramic water filters for drinking water treatment [ 16 , 17 , 18 , 19 ]. A study conducted in Kenya found that during six months of use, 71% of filtrate samples collected from locally produced ceramic pot filters contained less than 1 E. coli per 100 mL, and although intervention households reported less diarrhea, the difference was not significant [ 20 ]. Also, a recently conducted meta-analysis on the impact of drinking water, sanitation and handwashing with soap on childhood diarrhea found that interventions with filters to treat water at the point of consumption together with safe storage reduced diarrhea risk by 61% [ 12 ].…”

Emerging Trends in Clinical Tropical Medicine Research

“…Results were forwarded to receiving health-care officials in the United States. Morris et al 7 Water purification Water quality was improved with the use of ceramic filters (< 1 Escherichia coli/100 mL). Visits for diarrhea were fewer in households using filters, but the incidence of diarrhea was not decreased.…”

“…Another group included patient-oriented outcomes in the study design but ultimately emphasized a surrogate outcome when no significant effect was seen in the former. 7 Another theme was the importance of incorporation of both ends of the age spectrum. The inclusion of geriatric populations-a group that is often neglected but is increasing in size in tropical clinical research-was refreshing.…”

Drinking Water and Public Health Risk

“…• Suspended Solids and Heavy Metals: Microplastics > 0.7μm, lead, copper, mercury, cadmium, chromium, aluminium, nickel, etc [70][71][72][73][74][75][76].…”