Follow-Up Study to Assess the Use and Performance of Household Filters in Zambia

Peletz, Rachel; Simuyandi, Michelo; Simunyama, Martin; Sarenje, Kelvin; Kelly, Paul; Clasen, Thomas

doi:10.4269/ajtmh.13-0054

Cited by 12 publications

(8 citation statements)

References 18 publications

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“…The observed reductions in TTC contamination is consistent with other field-based studies of the LifeStraw filter, including version 1.0, a hanging model (Boisson et al, 2010;Peletz et al, 2013Peletz et al, , 2012 and version 2.0, the tabletop model (Rosa et al, 2014b). Levels of faecal contamination in the control arm and in intervention households whose sample did not come from the LifeStraw were similar to other studies in Rwanda among households not using a LifeStraw filter Rosa et al, 2014b).…”

Section: Discussionsupporting

confidence: 79%

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

Kirby

Nagel

Rosa

et al. 2017

International Journal of Hygiene and Environmental Health

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Kirby, M.A.; Nagel, C.L.; Rosa, G.; Umupfasoni, M.M.; Iyakaremye, L.; Clasen, T.F. (2017) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Graphical abstract ABSTRACTUnsafe 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.

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Section: Discussionsupporting

confidence: 79%

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

Kirby

Nagel

Rosa

et al. 2017

International Journal of Hygiene and Environmental Health

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“…Reductions in use have been found for PuR, boiling, chlorination, and SODIS after six months (83); similar reductions for the ceramic filter in rural Cambodia were mostly attributed to breakage (84). One HWTS exception is a LifeStraw Family filter intervention that targeted HIV-positive mothers in Zambia: Twelve months later, 90% of households reported using the filter (85).…”

Section: Sustained Usementioning

confidence: 77%

Safe Drinking Water for Low-Income Regions

Amrose¹,

Burt

Ray

2015

Annu. Rev. Environ. Resour.

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Well into the 21st century, safe and affordable drinking water remains an unmet human need. At least 1.8 billion people are potentially exposed to microbial contamination, and close to 140 million people are potentially exposed to unsafe levels of arsenic. Many new technologies, water quality assessments, health impact assessments, cost studies, and user preference studies have emerged in the past 20 years to further the laudable goal of safe drinking water for all. This article reviews (a) the current literature on safe water approaches with respect to their effectiveness in improving water quality and protectiveness in improving human health, (b) new work on the uptake and use of safe water systems among low-income consumers, (c) new research on the cash and labor costs of safe water systems, and (d) research on user preferences and valuations for safe water. Our main recommendation is that safe water from "source to sip" should be seen as a system; this entire system, rather than a discrete intervention, should be the object of analysis for technical, economic, and health assessments.

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“…In a 1‐year follow‐up RCT in Zambia, Peletz et al. () found that 53% of families were not storing their water properly. When water is stored improperly, contamination can occur despite the purity of the water directly after filtering.…”

Section: Literature Reviewmentioning

confidence: 99%

Acceptance and Impact of Point‐of‐Use Water Filtration Systems in Rural Guatemala

Larson

Hansen

Ritz

et al. 2016

J of Nursing Scholarship

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Purpose: Infants and children in developing countries bear the burden of diarrheal disease. Diarrheal disease is linked to unsafe drinking water and can result in serious long-term consequences, such as impaired immune function and brain growth. There is evidence that point-of-use water filtration systems reduce the prevalence of diarrhea in developing countries. In the summer of 2014, following community forums and interactive workshops, water filters were distributed to 71 households in a rural Maya community in Guatemala. The purpose of this study was to evaluate the uptake of tabletop water filtration systems to reduce diarrheal diseases. Design: A descriptive correlational study was used that employed community partnership and empowerment strategies. One year postintervention, in the summer of 2015, a bilingual, interdisciplinary research team conducted a house-to-house survey with families who received water filters. Methods: Survey data were gathered from the head of household on family demographics, current family health, water filter usage, and type of flooring in the home. Interviews were conducted in Spanish and in partnership with a village leader. Each family received a food package of household staples for their participation. Descriptive statistics were calculated for all responses. Fisher's exact test and odds ratios were used to determine relationships between variables. Findings: Seventy-nine percent (n = 56) of the 71 households that received a water filter in 2014 participated in the study. The majority of families (71.4%; n = 40) were using the water filters and 16 families (28.6%) had broken water filters. Of the families with working water filters, 15% reported diarrhea, while 31% of families with a broken water filter reported diarrhea. Only 55.4% of the homes had concrete flooring. More households with dirt flooring and broken water filters reported a current case of diarrhea. A record review of atten-dees at an outreach clinic in this village noted a decrease in intestinal infections from 2014 (53%) to 2015 (32%). Conclusions: A trend suggests that water filter usage was both practically and clinically significant in reducing the incidence of diarrheal disease in this sample. Some homes did not have flat surfaces for water filter storage. Housing conditions should be taken into consideration for future diarrheal disease prevention initiatives. Clinical Relevance: Point-of-use water filters using a community-university partnership can reduce diarrheal disease in rural regions of Guatemala.

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Follow-Up Study to Assess the Use and Performance of Household Filters in Zambia

Cited by 12 publications

References 18 publications

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

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

Safe Drinking Water for Low-Income Regions

Acceptance and Impact of Point‐of‐Use Water Filtration Systems in Rural Guatemala

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