Effectiveness of water treatment technologies to prevent child stunting in Limpopo, South Africa
Elizabeth Rogawski, PhD, MSPH
BACKGROUND: Exposure to enteropathogens in contaminated drinking water contributes to environmental enteropathy, an inflammatory condition of the gut, which can lead to poor linear growth, cognitive impairment, and increased risk of chronic disease later in life. Point-of-use water treatment technologies have the potential to provide effective and low-cost solutions to improve drinking water quality and may contribute to efforts to reduce child stunting.
GAP: One such technology, a silver-impregnated ceramic disk called the MadiDrop, continually disinfects water in household water storage containers by diffusing silver into the water for daily treatment of 10 to 15 liters for at least six months. While use of the MadiDrop has proven to be highly effective in treating water, it is unknown whether the use of this technology will translate to improvements in child growth and development outcomes.
HYPOTHESIS: We hypothesize that the MadiDrop will be associated with greater improvements in linear growth among children over two years of use compared to a safe storage water container or no intervention. We hypothesize that the mechanism for this effect will be through reduced enteropathogen burden in these children.
METHODS: This study is a community-based randomized controlled trial among households with a healthy child under 3 years of age in the Dzimauli communities in Limpopo, South Africa. Households will be randomized to receive a MadiDrop, a ceramic water filter, a safe-storage water container, or no intervention and will be followed for growth and cognitive outcomes for 2 and 7 years, respectively.
IMPACT: Estimates of effectiveness demonstrated in this trial will provide the necessary evidence base to support the scale-up of manufacturing and distribution of the MadiDrop to low-income communities. Ultimately, this intervention has the potential to contribute to the WHO target to reduce the number of stunted children under 5 years of age by 40% by 2025.
Website Link: https://globalhealth.virginia.edu/
This project is a collaboration between the University of Virginia and the University of Venda in Limpopo, South Africa.