Abstract
BackgroundSolar Disinfection (SODIS) of water is an economical, user-friendly, and environmentally safe household water treatment method that has been advocated as a means of decreasing the burden of diarrhea among children under 5 years of age. Laboratory studies have consistently shown the efficacy of the SODIS method to destroy waterborne pathogens. However, the evidence-based health effect of a SODIS intervention at the household level is limited. The main aim of the study was to examine the effectiveness of a SODIS intervention in reducing the incidence of diarrhea among under-five children.MethodsA community-based, cluster randomized controlled trial was conducted, over 6 months from 10 January to 7 July 2016, in 28 rural villages of northwest Ethiopia. In the intervention group, 384 children in 279 households received polyethylene terephthalate (PET) bottles, and in the control group 394 children in 289 households who continued to use their usual drinking-water sources were included in the trial. The study compared diarrheal incidence among the intervention group children who were exposed to SODIS household water treatment and the control group children who were not exposed to such water treatment. A generalized estimating equation (GEE) model was used to compute the adjusted incidence rate ratio and the corresponding 95% confidence interval.ResultsIn this trial, the overall SODIS compliance was 90.6%. The incidence of diarrhea was 8.3 episodes/100 person-week observations in the intervention group compared to 15.3 episodes/100 person-week observations in the control group. A statistically significant reduction was observed in the incidence of diarrhea in the intervention group compared to the control (adjusted IRR 0.60 (95% CI 0.52, 0.70) with a corresponding prevention of 40% (95% CI: 34, 48).ConclusionThe SODIS intervention substantially reduced the incidence of diarrhea among under-five children in a rural community of northwest Ethiopia. This indicates that a SODIS intervention is an invaluable strategy that needs to be integrated with the National Health Extension Program to be addressed to rural communities.Trial registrationClinical Trial Registry India, ID: CTRI/2017/09/009640. Registered retrospectively on 5 September 2017.
Highlights
Solar Disinfection (SODIS) of water is an economical, user-friendly, and environmentally safe household water treatment method that has been advocated as a means of decreasing the burden of diarrhea among children under 5 years of age
A community-based, cluster randomized controlled trial (RCT) conducted in 28 rural villages to assess the effectiveness of the SODIS method of household water treatment (HWT) in reducing diarrhea among children under 5 years of age is the first SODIS intervention study in Ethiopia
The study arrived at a scientific evidence that SODIS as a method of HWT has a potential role as a diarrheal disease prevention strategy
Summary
Solar Disinfection (SODIS) of water is an economical, user-friendly, and environmentally safe household water treatment method that has been advocated as a means of decreasing the burden of diarrhea among children under 5 years of age. The main aim of the study was to examine the effectiveness of a SODIS intervention in reducing the incidence of diarrhea among under-five children. Waterborne diarrheal diseases are prevalent globally in areas where drinking-water treatment is inadequate [1]. The consumption of contaminated water, inadequate sanitation and hygiene are the main (88%) contributors to an estimated four billion cases of diarrhea every year, causing 1.8 million deaths, out of which about 90% are children under 5 years of age [2, 3]. Though the Millennium Development Goal (MDG) of safe drinking-water has been globally achieved, 663 million people still relied on unimproved water sources in 2015. In sub-Saharan Africa where safe water coverage is less than 50%, about 319 million people lack access to improved water sources [7]
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