The consumption of contaminated water, inadequate sanitation and hygiene are the main contributors to an estimated four billion cases of diarrhea every year, causing 1.8 million deaths, out of which about 90% are children under 5 years of age. In Ethiopia, nearly 40 million people, mostly in rural areas, do not have access to safe drinking water and 90% of households do not treat their drinking water at home. Studies conducted in different parts of Ethiopia indicated that a 2-week prevalence of diarrhea among under-five children ranged from 23 to 31%.
The installation of large-scale water treatment plants in rural Ethiopia is difficult due to the scarcity of resources and scattered settlement. Therefore, low-cost home water treatment kits have been proposed as a potential solution in rural areas. One home based water treatment is solar water disinfection where raw water is filled into polyethylene terephthalate (PET) bottles and relies on the germicidal effects of sunlight and heat.
The study was conducted in Dabat district, northwest Ethiopia. The study area was divided into an intervention area using solar disinfection of water and a control area separated by a buffer zone to avoid contamination of information. Clusters were chosen by randomly selecting 14 villages from within each of the intervention and control study areas.
A total of 397 under five children in 280 households in the intervention and 400 under fives in 293 households in the control group were enrolled in 28 clusters (villages). The baseline analysis compared the socio-demographic and economic factors and there were no significant differences between the two groups. Water analysis showed similar high rates of contamination of raw water in both groups. During the baseline period, a 2-week prevalence of diarrhea was 20.8% (80/384) in the intervention and 21.8% (86/394) in the control groups was recorded.
During the active intervention phase, there were significantly fewer cases of diarrhea, i.e., 8.3 episodes per 100 person-week observations (378 episodes of diarrhea) among under fives in the solar disinfection intervention group and 15.3 episodes of diarrhea per 100 person-week observations (720 episodes of diarrhea) in the control during the entire 6-month consecutive follow-up. The overall prevention of diarrheal incidence among under fives during the 6 month solar disinfection intervention was 40% (95% CI 30–48) compared to the control group.
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