The impact of a school-based water supply and treatment, hygiene, and sanitation programme on pupil diarrhoea: a cluster-randomized trial

• Type of Material: Article
• Authors: Matthew Freeman, Emory University; Thomas Clasen, Emory University; R Dreibelbis, Emory University; S Saboori, Emory University; LE Greene, Emory University; B Brumback, University of Florida; R Muga, Great Lakes Univ Kisumu; Richard Rheingans, Emory University
• Language: English
• Date: 2014-02-01
• Publisher: CAMBRIDGE UNIV PRESS
• Publication Version: Final Published Version
• Copyright Statement: © Cambridge University Press 2013
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1017/S0950268813001118
• Title of Journal or Parent Work: EPIDEMIOLOGY AND INFECTION
• Volume: 142
• Issue: 2
• Start Page: 340
• End Page: 351
• Keywords: INTERVENTIONS; water (safe); waterborne infections; 21 REGIONS; DRINKING-WATER; MORBIDITY; Life Sciences & Biomedicine; Science & Technology; hand hygiene; water (quality); GLOBAL BURDEN; Diarrhoea; DISEASE; CHILD HEALTH; Public, Environmental & Occupational Health; SYSTEMATIC ANALYSIS; Infectious Diseases; CONTAMINATION; RECALL
• Research Categories: Biology, Biostatistics; Environmental Sciences

Abstract

The impact of improved water, sanitation, and hygiene (WASH) access on mitigating illness is well documented, although impact of school-based WASH on school-aged children has not been rigorously explored. We conducted a cluster-randomized trial in Nyanza Province, Kenya to assess the impact of a school-based WASH intervention on diarrhoeal disease in primary-school pupils. Two study populations were used: schools with a nearby dry season water source and those without. Pupils attending 'water-available' schools that received hygiene promotion and water treatment (HP&WT) and sanitation improvements showed no difference in period prevalence or duration of illness compared to pupils attending control schools. Those pupils in schools that received only the HP&WT showed similar results. Pupils in 'water-scarce' schools that received a water-supply improvement, HP&WT and sanitation showed a reduction in diarrhoea incidence and days of illness. Our study revealed mixed results on the impact of improvements to school WASH improvements on pupil diarrhoea. © 2013 Cambridge University Press.