The Effect of Improved Water Supply on Diarrhea Prevalence of Children under Five in the Volta Region of Ghana: A Cluster-Randomized Controlled Trial

Abstract

Although a number of studies have been conducted to explore the effect of water quality improvement, the majority of them have focused mainly on point-of-use water treatment, and the studies investigating the effect of improved water supply have been based on observational or inadequately randomized trials. We report the results of a matched cluster randomized trial investigating the effect of improved water supply on diarrheal prevalence of children under five living in rural areas of the Volta Region in Ghana. We compared the diarrheal prevalence of 305 children in 10 communities of intervention with 302 children in 10 matched communities with no intervention (October 2012 to February 2014). A modified Poisson regression was used to estimate the prevalence ratio. An intention-to-treat analysis was undertaken. The crude prevalence ratio of diarrhea in the intervention compared with the control communities was 0.85 (95% CI 0.74–0.97) for Krachi West, 0.96 (0.87–1.05) for Krachi East, and 0.91 (0.83–0.98) for both districts. Sanitation was adjusted for in the model to remove the bias due to residual imbalance since it was not balanced even after randomization. The adjusted prevalence ratio was 0.82 (95% CI 0.71–0.96) for Krachi West, 0.95 (0.86–1.04) for Krachi East, and 0.89 (0.82–0.97) for both districts. This study provides a basis for a better approach to water quality interventions.

Hygiene and Sanitation Practices and the Risk of Morbidity among Children 6–23 Months of Age in Kumbungu District, Ghana

“…Osumanu [16] also found a similar prevalence rate (57.5%) of diarrhoea among under-five years children from indigenous residential areas in the Tamale Metropolis of Ghana. Most recently, in the Volta Region of Ghana, diarrhoea prevalence rate of 44.7-59.2% was reported for intervention and control groups in a randomised trial [41]. It is worth noting that our sample was younger than the GDHS sample and younger children are more vulnerable to infections and poor health, which may also be related to poor care and dietary inadequacies and may also partly explain the high diarrhoea prevalence.…”

Water, sanitation and hygiene (WASH) Promotion: A qualitative analysis of experiences of stakeholders in rural KwaZulu-Natal

“…Majority of the participants could not afford water treatment products hence they drank untreated water from the river or unprotected dug wells. Previous studies have shown that covered water sources and treatment of water before consumption reduces the likelihood diarrheal diseases [2,[17][18][19] Although participants were able to link drinking untreated water and diseases, they had poor knowledge on transmission routes of schistosomiasis. Majority of the individuals interviewed believed that one can get infected with diarrhea and schistosomiasis by drinking contaminated water.…”

Morbidity benefit conferred by childhood immunisation in relation to maternal HIV status: a meta-analysis of demographic and health surveys

“…Improved water supply is one of the factors linked to reduction in episodes of diarrhoea. 21 It has been proven that households with improved water supply could reduce incidence of diarrhoea among under-five children in sub-Saharan Africa. 21 The use of pipe-borne water supply within a private household or yard is a major source of improved water supply.…”

“…21 It has been proven that households with improved water supply could reduce incidence of diarrhoea among under-five children in sub-Saharan Africa. 21 The use of pipe-borne water supply within a private household or yard is a major source of improved water supply. Other improved drinking water sources are public water taps, protected deep well, boreholes, collected rainwater and protected springs.…”