Aim: To measure diarrhoea burden, environmental hygiene and water quality in Kiribati, in order to assess whether a domestic water filter would be likely to improve child and community health.

Methods: Cross-sectional survey of randomly selected households using a questionnaire and analysis of drinking and source water samples.

Results: Female heads of 97 randomly selected households answered the questionnaire. One in four children younger than five years had experienced diarrhoea in the past month and 7% in the past week. Thirty-four percent of respondents and 57% of their children practised open defecation. Handwashing at important times was uncommon, as was safe water storage. Almost all households usually boil water. Overall, drinking water was less contaminated than source water (p = 0.05). Where paired samples of source and drinking water were available, drinking water that had been boiled was significantly less contaminated than source water (1 tailed t-test; p = 0.014).

Conclusion: Both ‘waterwashed’ and waterborne transmission are likely responsible for diarrhoea. In this setting where nearly all households boil water, in the absence of hygiene and storage improvements, the substitution of a filter is unlikely to improve water quality.

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