Assessing the impact of water filters and improved cook stoves on drinking water quality and household air pollution: a randomised controlled trial in Rwanda

Ghislaine Rosa, Fiona Majorin, Sophie Boisson, Christina Barstow, Michael Johnson, Miles Kirby, Fidele Ngabo, Evan Thomas, Thomas Clasen, Ghislaine Rosa, Fiona Majorin, Sophie Boisson, Christina Barstow, Michael Johnson, Miles Kirby, Fidele Ngabo, Evan Thomas, Thomas Clasen

Abstract

Diarrhoea and respiratory infections remain the biggest killers of children under 5 years in developing countries. We conducted a 5-month household randomised controlled trial among 566 households in rural Rwanda to assess uptake, compliance and impact on environmental exposures of a combined intervention delivering high-performance water filters and improved stoves for free. Compliance was measured monthly by self-report and spot-check observations. Semi-continuous 24-h PM2.5 monitoring of the cooking area was conducted in a random subsample of 121 households to assess household air pollution, while samples of drinking water from all households were collected monthly to assess the levels of thermotolerant coliforms. Adoption was generally high, with most householders reporting the filters as their primary source of drinking water and the intervention stoves as their primary cooking stove. However, some householders continued to drink untreated water and most continued to cook on traditional stoves. The intervention was associated with a 97.5% reduction in mean faecal indicator bacteria (Williams means 0.5 vs. 20.2 TTC/100 mL, p<0.001) and a median reduction of 48% of 24-h PM2.5 concentrations in the cooking area (p = 0.005). Further studies to increase compliance should be undertaken to better inform large-scale interventions.

Trial registration: Clinicaltrials.gov; NCT01882777; https://ichgcp.net/clinical-trials-registry/NCT01882777&Search=Search.

Conflict of interest statement

Competing Interests: We have the following interests: This study was funded by DelAgua Health, a for-profit company that implements the program in Rwanda in conjunction with the Rwanda Ministry of Health. Evan Thomas and Christina Barstow, co-authors of this article, are compensated consultants to DelAgua Health, and are in charge of overseeing the implementation of the program in Rwanda. Michael Johnson, co-authors of this article, is employed by the commercial company, Berkeley Air Monitoring Group, which was contracted to provide advice on household air pollution monitoring. This does not alter our adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1. CONSORT diagram showing the flow…
Figure 1. CONSORT diagram showing the flow of participants through the trial.
Figure 2. Percentage of water samples by…
Figure 2. Percentage of water samples by level of contamination (TTC/100 mL).

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Source: PubMed

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