1. An Evaluation Of The Effectiveness Of Household Water Treatment In Reducing Diarrhoea Among Vulnerable Groups In Nigeria
Ekundayo D. Arogundade, Samson B. Adebayo,& Wale Adedeji
Society for Family Health, Abuja, Nigeria
Background
In Nigeria, 27% of infant morbidity and 24% of infant and childhood mortality is a result of diarrheal diseases. The majority of the rural population (which accounts for 75% of Nigeria's 140 million residents) lack access to safe water and basic sanitation. Household water treatment using a dilute sodium hypochlorite solution combined with improved hygienic practices and safe water storage has been shown to be effective in preventing diarrhoea. This study examined the utilisation of point of use of a water disinfectant (Water Guard) and diarrhoea episodes in 22 states in Nigeria.
Method
Questionnaires administered to 7,222 caregivers of children under five in 2008
Eligible respondents were selected through a multi-stage probability sampling design.
Fisher's exact test of association was used to investigate any possible relationship between use of WaterGuard and evidence of diarrhoea.
A mutilvariate logistic regression was also used to explore the impact of WaterGuard on some demographic characteristics.
Results
Overall, 2,812 caregivers either treated, boiled, filtered or sieved water for their under five children before giving them to drink.
405 (14.4%) had evidence of diarrhoea in their households in the last two weeks prior to the survey.
Approximately a fifth (21.0%) of the caregivers had never attended school, 13.3% had Qur'anic education, 21.8% had primary education, 33.5% had secondary education and only 10.3% had higher education
About half of the households used water from either a well (26%) or stream (12.7%).
18% get water from street (public) tap, 5.6% from water vendors, 2.3% from water tankers and about 25% from boreholes
Findings revealed that 14.4% had diarrhoea in the last two weeks prior to the survey: 12.6% in the urban and 16.1% in the rural localities
86.7 % mentioned that children under five years are most vulnerable to diarrhoea, only 39.1% boil, sieve, filter, added alum or chemicals to make water safe to drink for children under five
It was evident that the proportion of those who had diarrhoea was significantly higher among non-users of Waterguard compared with the proportion of those who had diarrhoea among users of Waterguard (p < 0.043)
Conclusions
Waterguard has been shown to be effective in reducing incidence of diarrhoea especially when good hygiene behaviour is ensured.
It was evident from this study that respondents in the rural areas were disproportionately affected by poor hygiene situation. This may be due to lack of access to proper education on sanitary and environmental hygiene which is often usually available in the urban areas. This in turn may be related to socio-economic class of the households that the respondents come from. Interventions on this should ensure that such localities (rural areas) are adequately catered for.
This suggests that there is need for a possible scaling up of intervention among the Nigerian populace especially in the rural areas.
There is also a need to increase awareness on good hygiene practices which in turn will help reduce child mortality caused by diarrhoea and other gastro-intestinal infection of children under five.
Society for Family Health, Abuja, Nigeria
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