Impact of low-cost point-of-use water treatment technologies on enteric infections and growth among children in limpopo, South Africa

Courtney L. Hill, Kelly McCain, Mzwakhe E. Nyathi, Joshua N. Edokpayi, David M. Kahler, Darwin J. Operario, David D.J. Taylor, Natasha C. Wright, James A. Smith, Richard L. Guerrant, Amidou Samie, Rebecca A. Dillingham, Pascal O. Bessong, Elizabeth T. Rogawski McQuade

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Enteric infections early in life have been associated with poor linear growth among children in low-resource settings. Point-of-use water treatment technologies provide effective and low-cost solutions to reduce exposure to enteropathogens from drinking water, but it is unknown whether the use of these technologies translates to improvements in child growth. We conducted a community-based randomized controlled trial of two water treatment technologies to estimate their effects on child growth in Limpopo, South Africa. We randomized 404 households with a child younger than 3 years to receive a silver-impregnated ceramic water filter, a silver-impregnated ceramic tablet, a safe-storage water container alone, or no intervention, and these households were followed up quarterly for 2 years. We estimated the effects of the interventions on linear and ponderal growth, enteric infections assessed by quantitative molecular diagnostics, and diarrhea prevalence. The silver-impregnated ceramic water filters and tablets consistently achieved approximately 1.2 and 3 log reductions, respectively, in total coliform bacteria in drinking water samples. However, the filters and tablets were not associated with differences in height (height-for-age z-score differences compared with no intervention: 0.06, 95% CI: −0.29, 0.40, and 0.00, 95% CI: −0.35, 0.35, respectively). There were also no effects of the interventions on weight, diarrhea prevalence, or enteric infections. Despite their effectiveness in treating drinking water, the use of the silver-impregnated ceramic water filters and tablets did not reduce enteric infections or improve child growth. More transformative water, sanitation, and hygiene interventions that better prevent enteric infections are likely needed to improve long-term child growth outcomes.

Original languageEnglish (US)
Pages (from-to)1405-1415
Number of pages11
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume103
Issue number4
DOIs
StatePublished - Oct 2020

Bibliographical note

Publisher Copyright:
Copyright © 2020 by The American Society of Tropical Medicine and Hygiene

Fingerprint

Dive into the research topics of 'Impact of low-cost point-of-use water treatment technologies on enteric infections and growth among children in limpopo, South Africa'. Together they form a unique fingerprint.

Cite this