Diarrhea prevalence in a randomized, controlled prospective trial of point-of-use water filters in homes and schools in the Dominican Republic

Abstract

Background Lack of sustainable access to clean drinking water continues to be an issue of paramount global importance, leading to millions of preventable deaths annually. Best practices for providing sustainable access to clean drinking water, however, remain unclear. Widespread installation of low-cost, in-home, point of use water filtration systems is a promising strategy. Methods We conducted a prospective, randomized, controlled trial whereby 16 villages were selected and randomly assigned to one of four treatment arms based on the installation location of Sawyer® PointONE™ filters (filter in both home and school; filter in home only; filter in school only; control group). Water samples and self-reported information on diarrhea were collected at multiple times throughout the study. Results Self-reported household prevalence of diarrhea decreased from 25.6 to 9.76% from installation to follow-up (at least 7 days, and up to 200 days post-filter installation). These declines were also observed in diarrhea with economic or educational consequences (diarrhea which led to medical treatment and/or missing school or work) with baseline prevalence of 9.64% declining to 1.57%. Decreases in diarrhea prevalence were observed across age groups. There was no evidence of a loss of efficacy of filters up to 200 days post-filter installation. Installation of filters in schools was not associated with decreases in diarrhea prevalence in school-aged children or family members. Unfiltered water samples both at schools and homes contained potential waterborne bacterial pathogens, dissolved heavy metals and metals associated with particulates. All dissolved metals were detected at levels below World Health Organization action guidelines. Conclusions This controlled trial provides strong evidence of the effectiveness of point-of-use, hollow fiber membrane filters at reducing diarrhea from bacterial sources up to 200 days post-installation when installed in homes. No statistically significant reduction in diarrhea was found when filters were installed in schools. Further research is needed in order to explore filter efficacy and utilization after 200 days post-installation. Trial registration ClinicalTrials.gov, NCT03972618. Registered 3 June 2019—retrospectively registered.

Coronavirus disease 2019 vaccine acceptance and perceived barriers among university students in northeast Ethiopia: A cross-sectional study

“…16 , 47 The other explanation might be the perceived barriers towards the vaccine. 48 In the present study, more than two-thirds and slightly more than half of the participants who were not accept the vaccine due to perceived vaccine side effects and uncertainty about its effectiveness respectively. In this regard, the concerned stakeholders such as the federal ministry of health, the regional health bureau, and the Media should disseminate factual information to the community thereby building trust, having a wide coverage of vaccination, and eliminating the pandemic in the long run.…”

The Willingness to Receive COVID-19 Vaccine and Its Associated Factors: “Vaccination Refusal Could Prolong the War of This Pandemic” – A Systematic Review

“…The study design of all these studies were cross-sectional. Nine studies were done in the United States, 30–38 nine studies were done in China, 39–47 one study was done in Australia, 48 four studies were done in Saudi Arabia, 49–52 one study was done in Kuwait, 53 one study was done in England, 54 one study was done in Congo, 55 one study was done in Greece, 56 two studies were done in UK, 57 , 58 one study was done in Malaysia, 59 two studies were done in Japan, 60 , 61 one study was done in Israel, 62 one study was done in Bangladesh, 63 one study was done in Jordan, 64 one study was done in Iran, 65 one study was done in Italy, 66 one study was done in Ethiopia, 67 two studies were done in France, 68 , 69 one study was done in Vietnam, 70 one study was done in Uganda, 71 one study was done in Pakistan, 72 one study was done in Nigeria, 73 and one study was done in Latin America and the Caribbean (LAC). 74 The smallest sample size was 409 and the largest was 472,521, which was reported from Ethiopia, 67 and LAC, 74 respectively ( Table 1 ).…”

“… 35 Huynh et al 70 2021 410 HCWs CS Vietnam 76.10% Perceived susceptibility and severity of COVID-19, perceived benefits of vaccination, Perceived barriers, and cues to action. 36 Kanyike et al 71 2021 600 Medical Students CS Uganda 37.3% Gender (female), marital status (single), perceived risk of getting COVID-19 in the future, receiving any vaccine in the past 5 years, and COVID-19 vaccine hesitancy. 37 Luodan et al 44 2020 8040 HCWs CS China 67.1% Perception of disease severity, self-infection risk and disease can be prevented by vaccine.…”

“…Concerning to the associated factors, from a total of 45 studies included in the present systematic review, 39 of the studies have assessed the associated factors with individuals’ willingness of receiving COVID-19 vaccine. From 39 studies assessed the associated factors with willingness of receiving COVID-19 vaccine, some of the studies have reported that sociodemographic factors such as age, 32 , 35–37 , 39 , 43 , 48 , 49 , 56 , 58 , 60 , 61 , 65 , 68 , 69 , 72 , 73 educational status, 30–32 , 36 , 43 , 72 gender, 32 , 35–37 , 47 , 48 , 52 , 53 , 55 , 59–61 , 65 , 68 , 69 , 71–74 income, 36 , 54 , 61 residency, 36 , 60 , 74 occupation, 54 , 62 marital status, 47 , 49 , 71 and race/ethnicity 32 , 35 , 37 , 54 were factors associated with willingness of receiving COVID-19 vaccine. This might be due to that education is a powerful strategy to disseminate the essential information about the health of individuals.…”

COVID-19 vaccination hesitancy in students and trainees of healthcare professions: A global assessment and call for action

“…Furthermore, studies have shown that individuals are more likely to accept COVID-19 vaccination if it is recommended by healthcare providers. If acceptance of COVID-19 vaccines remains lower in healthcare professionals, it remains unclear how they will be able to build confidence in patients and recommend the available vaccines ( Kanyike et. al.…”