Evaluation of the Impact of the Plastic BioSand Filter on Health and Drinking Water Quality in Rural Tamale, Ghana

Stauber, Christine E.; Kominek, Byron; Liang, Kaida; Osman, Mumuni K.; Sobsey, Mark D.

doi:10.3390/ijerph9113806

Cited by 39 publications

(27 citation statements)

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“…Of these, six studies had two relevant intervention arms (Austin 1993; URL 1995; Luby 2004; Crump 2005; Brown 2008; Lindquist 2014), two had three arms (Luby 2006; Opryszko 2010), and one had four arms (Reller 2003), making a total of 65 discrete comparisons. Three included studies had inadequate information on disease morbidity to include in the quantitative analysis (Torun 1982 GTM; Kremer 2011 KEN; Patel 2012 KEN). We contacted the study authors for further information, but no data could be provided.…”

Section: Resultsmentioning

confidence: 99%

“…Among the eight studies investigating interventions to improve water quality at the point of distribution, only four tested microbiological water quality (Torun 1982 GTM; Gasana 2002 RWA; Jensen 2003 PAK; Kremer 2011 KEN). As these tests were at the source or point of distribution and not the POU, their results do not reflect possible post-collection contamination.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies evaluated source-based interventions: improved wells or boreholes (Alam 1989 BGD; Xiao 1997 CHN; Opryszko 2010b AFG; Opryszko 2010c AFG) or improved community sources and distribution to public tap stands (Torun 1982 GTM; Gasana 2002 RWA; Jensen 2003 PAK; Kremer 2011 KEN; Majuru 2011 ZAF); none evaluated reliable piped-in household connections.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-six studies used the WHO's definition of diarrhoea, while other studies used the following definitions: the mother's or respondent's definition (Austin 1993; Gasana 2002 RWA; Reller 2003; Crump 2005; Chiller 2006 GTM); 'watery diarrhoea as a component of gastroenteritis' (Colford 2002 USA; Colford 2005 USA; Colford 2009 USA; Rodrigo 2011 AUS); the local term (Conroy 1996 KEN; Conroy 1999 KEN; Boisson 2009 ETH); "significant change in bowel habits towards decreased consistency or increased frequency" (Kirchhoff 1985 BRA); or dysentery (du Preez 2010 ZAF; du Preez 2011 KEN). Four studies did not report the case definition used for diarrhoea (Torun 1982 GTM; Xiao 1997 CHN; Günther 2013 BEN; Lindquist 2014). …”

Section: Resultsmentioning

confidence: 99%

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Interventions to improve water quality for preventing diarrhoea

Clasen

Alexander

Sinclair

et al. 2015

Cochrane Database of Systematic Reviews

250

159

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BackgroundDiarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces.In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home.ObjectivesTo assess the effectiveness of interventions to improve water quality for preventing diarrhoea.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014.Selection criteriaRandomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults.Data collection and analysisTwo review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach.Main resultsForty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with unimproved water sources (30 studies) and unimproved or unclear sanitation (34 studies). The primary outcome in most studies was self-reported diarrhoea, which is at high risk of bias due to the lack of blinding in over 80% of the included studies.Source-based water quality improvementsThere is currently insufficient evidence to know if source-based improvements such as protected wells, communal tap stands, or chlorination/filtration of community sources consistently reduce diarrhoea (one cluster-RCT, five CBA studies, very low quality evidence). We found no studies evaluating reliable piped-in water supplies delivered to households.Point-of-use water quality interventionsOn average, distributing water disinfection products for use at the household level may reduce diarrhoea by around one quarter (Home chlorination products: RR 0.77, 95% CI 0.65 to 0.91; 14 trials, 30,746 participants, low quality evidence; flocculation and disinfection sachets: RR 0.69, 95% CI 0.58 to 0.82, four trials, 11,788 participants, moderate quality evidence). However, there was substantial h...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Interventions to improve water quality for preventing diarrhoea

Clasen

Alexander

Sinclair

et al. 2015

Cochrane Database of Systematic Reviews

250

159

View full text Add to dashboard Cite

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“…It is also possible that because more than 50% of the population had access to an improved source of drinking water, the impact of the plastic BSF on water quality and hygiene, and toy contamination was reduced compared to conditions where a smaller proportion of households were using improved water. Additional geographic and hygiene status locations, where the majority of households are using untreated surface water for drinking such as in the RCT of the plastic BSF performed in Ghana would be another important setting in which to perform a similar pilot toy study [19]. …”

Section: Resultsmentioning

confidence: 99%

Bacterial Contamination on Household Toys and Association with Water, Sanitation and Hygiene Conditions in Honduras

Stauber

Walters

Aceituno

et al. 2013

IJERPH

Self Cite

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There is growing evidence that household water treatment interventions improve microbiological water quality and reduce diarrheal disease risk. Few studies have examined, however, the impact of water treatment interventions on household-level hygiene and sanitation. This study examined the association of four water and sanitation conditions (access to latrines, improved sanitation, improved water and the plastic biosand filter) on the levels of total coliforms and E. coli on existing and introduced toys during an on-going randomized controlled trial of the plastic biosand filter (plastic BSF). The following conditions were associated with decreased bacterial contamination on children’s toys: access to a latrine, access to improved sanitation and access to the plastic BSF. Overall, compared to existing toys, introduced toys had significantly lower levels of both E. coli and total coliforms. Results suggest that levels of fecal indicator bacteria contamination on children’s toys may be associated with access to improved water and sanitation conditions in the home. In addition, the fecal indicator bacteria levels on toys probably vary with duration in the household. Additional information on how these toys become contaminated is needed to determine the usefulness of toys as indicators or sentinels of water, sanitation and hygiene conditions, behaviors and risks.

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Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low‐ and middle‐income countries: An evidence and gap map of effectiveness studies

Chirgwin

Cairncross

Zehra

et al. 2021

Campbell Systematic Reviews

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Background Lack of access to and use of water, sanitation and hygiene (WASH) cause 1.6 million deaths every year, of which 1.2 million are due to gastrointestinal illnesses like diarrhoea and acute respiratory infections like pneumonia. Poor WASH access and use also diminish nutrition and educational attainment, and cause danger and stress for vulnerable populations, especially for women and girls. The hardest hit regions are sub‐Saharan Africa and South Asia. Sustainable Development Goal (SDG) 6 calls for the end of open defecation, and universal access to safely managed water and sanitation facilities, and basic hand hygiene, by 2030. WASH access and use also underpin progress in other areas such as SDG1 poverty targets, SDG3 health and SDG4 education targets. Meeting the SDG equity agenda to “leave none behind” will require WASH providers prioritise the hardest to reach including those living remotely and people who are disadvantaged. Objectives Decision makers need access to high‐quality evidence on what works in WASH promotion in different contexts, and for different groups of people, to reach the most disadvantaged populations and thereby achieve universal targets. The WASH evidence map is envisioned as a tool for commissioners and researchers to identify existing studies to fill synthesis gaps, as well as helping to prioritise new studies where there are gaps in knowledge. It also supports policymakers and practitioners to navigate the evidence base, including presenting critically appraised findings from existing systematic reviews. Methods This evidence map presents impact evaluations and systematic reviews from the WASH sector, organised according to the types of intervention mechanisms, WASH technologies promoted, and outcomes measured. It is based on a framework of intervention mechanisms (e.g., behaviour change triggering or microloans) and outcomes along the causal pathway, specifically behavioural outcomes (e.g., handwashing and food hygiene practices), ill‐health outcomes (e.g., diarrhoeal morbidity and mortality), nutrition and socioeconomic outcomes (e.g., school absenteeism and household income). The map also provides filters to examine the evidence for a particular WASH technology (e.g., latrines), place of use (e.g., home, school or health facility), location (e.g., global region, country, rural and urban) and group (e.g., people living with disability). Systematic searches for published and unpublished literature and trial registries were conducted of studies in low‐ and middle‐income countries (LMICs). Searches were conducted in March 2018, and searches for completed trials were done in May 2020. Coding of information for the map was done by two authors working independently. Impact evaluations were critically appraised according to methods of conduct and reporting. Systematic reviews were critically appraised using a new approach to assess theory‐based, mixed‐methods evidence synthesis. Results There has been an enormous growth in impact evaluations and systematic reviews of WASH ...

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Evaluation of the Impact of the Plastic BioSand Filter on Health and Drinking Water Quality in Rural Tamale, Ghana

Cited by 39 publications

References 28 publications

Interventions to improve water quality for preventing diarrhoea

Interventions to improve water quality for preventing diarrhoea

Bacterial Contamination on Household Toys and Association with Water, Sanitation and Hygiene Conditions in Honduras

Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low‐ and middle‐income countries: An evidence and gap map of effectiveness studies

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