Abstract
Adequate provision of safe water, basic sanitation, and hygiene (WASH) facilities and behavior change can reduce pupil absence and infectious disease. Increased drinking water quantity may also improve educational outcomes through the effect of hydration on attention, concentration, and short-term memory. A pilot study was conducted to adapt field measures of short-term cognitive performance and hydration, to evaluate levels of hydration, and to investigate the impact of providing supplementary drinking water on the cognitive performance of pupils attending water-scarce schools in rural Mali. Using a cross-over trial design, data were collected under normal school conditions (control condition) on one visit day; on the other, participants were given a bottle of water that was refilled throughout the day (water condition). Morning and afternoon hydration was assessed using specific gravity and urine color. Cognitive performance was evaluated using six paper-based tests. Three percent of pupils were dehydrated on the morning of each visit. The prevalence of dehydration increased in the afternoon, but was lower under the water condition. Although there was a trend indicating drinking water may improve cognitive test performance, as has been shown in studies in other settings, results were not statistically significant and were masked by a “practice effect.”
Highlights
3% of pupils were classified as dehydrated in the morning according to urine specific gravity (Usg) (Usg>1.019), regardless of visit day or study condition
The difference between water and control condition mean morning Usg or urine color (Ucol) was not statistically significant, and we found no difference in the prevalence of dehydration prior to distribution of water
Our results demonstrated no significant difference between self-reported thirst among pupils under the water condition compared to the control condition, even though the measurements of Usg indicated that pupils under the water condition had significantly higher levels of hydration than pupils under the control condition
Summary
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Health and educational benefits associated with improved water, sanitation, and hygiene (WASH) in schools include reduced diarrhea, absence, acute respiratory infection, and soiltransmitted helminth infection [1,2,3,4,5]. The availability of water during the school day is essential for supporting personal hygiene, sanitation, and maintaining a clean school environment. Increased access to water for drinking at school may directly affect pupils’ academic performance through the cognitive benefits associated with decreased dehydration [6,7,8]
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