A randomized controlled trial of four interventions was conducted using tubewells (n=2,486), liquid sodium hypochlorite (‘Clorin’) distributed with an improved water vessel (n=2,305), hygiene promotion (n=1,877), and a combination of the three (n=2,040) to create an evidence-base for water policy in Afghanistan. A fifth group served as a control (n=2,377). Interventions were randomized across 32 villages in Wardak province. Outcomes were measured through two household surveys separated by one year and twice-weekly household surveillance conducted over 16 months. The households receiving all three interventions showed reduction in diarrhoea compared with the control group, through both longitudinal surveillance data (IRR [95% CI]=0.61 [0.47–0.81]) and cross-sectional survey data (AOR [95% CI]=0.53 [0.30–0.93]). This reduction was significant when all household members were included, but did not reach significance when only children under five were considered. These results suggest multi-barrier methods are necessary where there are many opportunities for water contamination. Surveillance data suggested a greater impact of interventions on reducing diarrhoeal diseases than data from the surveys. Higher economic status as measured through household assets was associated with lower rates of diarrhoea and greater intervention uptake, excepting Clorin. Use of soap was also associated with lower prevalence of diarrhoea.
Skip Nav Destination
Article navigation
Research Article|
April 22 2010
Water and hygiene interventions to reduce diarrhoea in rural Afghanistan: a randomized controlled study
Melissa C. Opryszko;
Melissa C. Opryszko
1Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E8132, Baltimore, MD 21205, USA
Search for other works by this author on:
Sayed Waheedullah Majeed;
Sayed Waheedullah Majeed
2Office of Water Quality, Sanitation and Hygiene Education, Ministry of Public Health, Islamic Republic of Afghanistan
Search for other works by this author on:
Peter M. Hansen;
Peter M. Hansen
1Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E8132, Baltimore, MD 21205, USA
Search for other works by this author on:
Jessica A. Myers;
Jessica A. Myers
1Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E8132, Baltimore, MD 21205, USA
Search for other works by this author on:
Duza Baba;
Duza Baba
1Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E8132, Baltimore, MD 21205, USA
Search for other works by this author on:
Richard E. Thompson;
Richard E. Thompson
1Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E8132, Baltimore, MD 21205, USA
Search for other works by this author on:
Gilbert Burnham
1Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E8132, Baltimore, MD 21205, USA
Tel.: +1 410 955 7934 Fax: +1 410 614 1419; E-mail: [email protected]
Search for other works by this author on:
J Water Health (2010) 8 (4): 687–702.
Article history
Received:
August 21 2009
Accepted:
December 18 2009
Citation
Melissa C. Opryszko, Sayed Waheedullah Majeed, Peter M. Hansen, Jessica A. Myers, Duza Baba, Richard E. Thompson, Gilbert Burnham; Water and hygiene interventions to reduce diarrhoea in rural Afghanistan: a randomized controlled study. J Water Health 1 December 2010; 8 (4): 687–702. doi: https://doi.org/10.2166/wh.2010.121
Download citation file: