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The Effect of Improved Water Supply on Diarrhea Prevalence of Children under Five in the Volta Region of Ghana: A Cluster-Randomized Controlled Trial

Author

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  • Seungman Cha

    (Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do 13449, Republic of Korea
    Department of Disease Control, Faculty of Infectious and Tropical Disease, London School of Hygiene & Tropical Medicine, Keppel Street London WC1E 7HT, London, UK)

  • Douk Kang

    (World Vision Korea, 77-1, Yeouinaru-ro, Yeongdeungpo-gu, Seoul, 07327, Republic of Korea)

  • Benedict Tuffuor

    (Training Research and Networking for Development, Post Office. Box Cantonments 6135, Cantonments, Accra, Ghana)

  • Gyuhong Lee

    (Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do 13449, Republic of Korea)

  • Jungmyung Cho

    (Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do 13449, Republic of Korea)

  • Jihye Chung

    (World Vision Korea, 77-1, Yeouinaru-ro, Yeongdeungpo-gu, Seoul, 07327, Republic of Korea)

  • Myongjin Kim

    (Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do 13449, Republic of Korea)

  • Hoonsang Lee

    (Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do 13449, Republic of Korea)

  • Jaeeun Lee

    (Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do 13449, Republic of Korea)

  • Chunghyeon Oh

    (Korea International Cooperation Agency, 825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeongo-do 13449, Republic of Korea)

Abstract

Although a number of studies have been conducted to explore the effect of water quality improvement, the majority of them have focused mainly on point-of-use water treatment, and the studies investigating the effect of improved water supply have been based on observational or inadequately randomized trials. We report the results of a matched cluster randomized trial investigating the effect of improved water supply on diarrheal prevalence of children under five living in rural areas of the Volta Region in Ghana. We compared the diarrheal prevalence of 305 children in 10 communities of intervention with 302 children in 10 matched communities with no intervention (October 2012 to February 2014). A modified Poisson regression was used to estimate the prevalence ratio. An intention-to-treat analysis was undertaken. The crude prevalence ratio of diarrhea in the intervention compared with the control communities was 0.85 (95% CI 0.74–0.97) for Krachi West, 0.96 (0.87–1.05) for Krachi East, and 0.91 (0.83–0.98) for both districts. Sanitation was adjusted for in the model to remove the bias due to residual imbalance since it was not balanced even after randomization. The adjusted prevalence ratio was 0.82 (95% CI 0.71–0.96) for Krachi West, 0.95 (0.86–1.04) for Krachi East, and 0.89 (0.82–0.97) for both districts. This study provides a basis for a better approach to water quality interventions.

Suggested Citation

  • Seungman Cha & Douk Kang & Benedict Tuffuor & Gyuhong Lee & Jungmyung Cho & Jihye Chung & Myongjin Kim & Hoonsang Lee & Jaeeun Lee & Chunghyeon Oh, 2015. "The Effect of Improved Water Supply on Diarrhea Prevalence of Children under Five in the Volta Region of Ghana: A Cluster-Randomized Controlled Trial," IJERPH, MDPI, vol. 12(10), pages 1-17, September.
    • Handle: RePEc:gam:jijerp:v:12:y:2015:i:10:p:12127-12143:d:56427
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    References listed on IDEAS

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    1. Esrey, S.A. & Habicht, J.-P. & Latham, M.C. & Sisler, D.G. & Casella, G., 1988. "Drinking water source, diarrheal morbidity, and child growth in villages with both traditional and improved water supplies in rural Lesotho, Southern Africa," American Journal of Public Health, American Public Health Association, vol. 78(11), pages 1451-1455.
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    Cited by:

    1. Paul H. McClelland & Claire T. Kenney & Federico Palacardo & Nicholas L. S. Roberts & Nicholas Luhende & Jason Chua & Jennifer Huang & Priyanka Patel & Leonardo Albertini Sanchez & Won J. Kim & John K, 2022. "Improved Water and Waste Management Practices Reduce Diarrhea Risk in Children under Age Five in Rural Tanzania: A Community-Based, Cross-Sectional Analysis," IJERPH, MDPI, vol. 19(7), pages 1-18, April.
    2. Emily Ying Yang Chan & Kimberley Hor Yee Tong & Caroline Dubois & Kiara Mc Donnell & Jean H. Kim & Kevin Kei Ching Hung & Kin On Kwok, 2021. "Narrative Review of Primary Preventive Interventions against Water-Borne Diseases: Scientific Evidence of Health-EDRM in Contexts with Inadequate Safe Drinking Water," IJERPH, MDPI, vol. 18(23), pages 1-20, November.

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