Reduction in diarrhoea rates after household water filter distribution in small and remote communities in Liberia

Abstract

Diarrhoea is the second-leading cause of death in Liberia, a sub-Saharan African country of 4.8 million people, with a majority living in rural villages. Diarrhoea has often been linked with poor water quality and malnutrition. Three organisations partnered to distribute point-of-use (POU) water filters to every household in Liberia without other access to safe water, documenting the distribution of filters to 101,706 households. Each such household was surveyed at a baseline, two weeks, and eight weeks. In addition to household characteristics, the prevalence of diarrhoea was reported at each survey. Our goal was to determine the extent of the impact that POU filter use had on diarrhoea prevalence by age group, controlling for effects of water source, location, and household size. Overall, there was a 94.2% decrease in diarrhoea cases from baseline to the 8-week follow-up. We discuss the success of the intervention in decreasing diarrhoea prevalence. The filter distribution focused on reaching remote villages, and providing access to clean water where there was none before. This study confirms that community-wide access to clean drinking water can reduce diarrhoea prevalence.

Keywords:

• diarrhoea
• Liberia
• POU filter
• clean water

Acknowledgments

The authors would like to acknowledge other team members and organisations who have contributed to the project: Grace M. Bolt, Rebekah Cross, Yue He, Megumu Jansen, Kyuhyun Jeong, Kate McClain, Hallie Miller, Abbi Stratton, Samuel Zeleke, and Sebrina Zeleke of Calvin University; Darrel Larson of Sawyer Products, Inc.; staff of the Last Well; and all of the organisations and individuals in Liberia, who worked tirelessly to ensure that everyone in their nation has access to clean water.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data are not available due to the protection of participant privacy.

Additional information

Funding

Portions of the authors’ time and materials were supported by a grant from Sawyer Products, Inc

Notes on contributors

K. R. Alford

Dr. Kristen Alford is currently a consultant working with the National Association of Chronic Disease Directors. She previously served as an associate professor of public health and social work at Calvin University.

L. K. Walls

Lydia Walls carried out this work during undergraduate studies at Calvin University, while working as a summer research fellow in Public Health.

S. L. DeRuiter

Dr. Stacy DeRuiter is associate professor of Mathematics and Statistics at Calvin University.

R Pruim

Dr. Randall Pruim is a professor of Mathematics and Statistics and co-director of the undergraduate and graduate data science programs at Calvin University.

J. E. VanHorn

Dr. Jason E. VanHorn is a Professor of Geography and expert in GIS, cartography, and remote sensing.

M. Bone

Matthew Bone carried out this work during undergraduate studies at Calvin University, while working as a summer research fellow in Statistics.

J. Deighton

Jared Deighton is a Ph.D. Candidate and Graduate Research Assistant at The University of Tennessee, Knoxville. He studies the intersection between neuroscience and machine learning through the lens of applied mathematics. He carried out this work during his undergraduate studies at Calvin University while working as a summer research fellow in Statistics.

J. Koeman

Jamison Koeman carried out this work during his undergraduate studies at Calvin University, while working as a summer research fellow in Public Health. He is now the program manager of two research initiatives on housing and urban health at the University of Michigan School of Public Health.

S. Kornoelje

Sadie Kornoelje carried out this work during undergraduate studies at Calvin University, while working as a summer research fellow in Statistics.

A. Koroma

Abdul Hafiz Koroma completed this research as part of his work with The Last Well. Currently, Abdul is a Subject Matter Expert with Social Impact in the USAID Human Resources for WASH Assessment in Liberia Project.

R. LeTourneau

Randy LeTourneau had 20+ years working in IT with for-profit companies and has since used his technology experience in serving in several non-profit organizations. Randy was the VP of Field Operations for The Last Well and was responsible for the implementation of the interventions of this study. He later moved to be the Director of Monitoring and Evaluation for The Bucket Ministry. Along with a career in global IT, Randy has traveled to or worked in 32 different countries with extensive ministry in Peru, Ecuador, Colombia, Kenya and Liberia.

B. Lika

Blerta Lika carried out this work during undergraduate studies at Calvin University, while working as a summer research fellow in Statistics.

K. Rosendale

Katherine Rosendale carried out this work during her undergraduate studies at Calvin University, while working as a summer research fellow in public health. She currently works in journalism.

N. Wang

Nathan Wang carried out this work during his Bachelor of Computer Science program at Calvin University, while working as a summer research fellow in the Department of Statistics.