An Evaluation of the Effectiveness of Household Water Treatment in Reducing Diarrhea among Vulnerable Groups in Nigeria

Background: In Nigeria, 27% of infant morbidity and 24% of infant and childhood mortality is a result of diarrheal diseases. The majority of the rural population (which account for 75% of Nigeria's 140 million residents) lack access to safe water and basic sanitation. Household water treatment using a dilute sodium hypochlorite solution combined with improved hygienic practices and safe water storage has been shown to be effective in preventing diarrhea. This study examined the utilization of point of use of a water disinfectant (WaterGuard) and diarrhea episodes in 22 states in Nigeria.

Methods: Surveys were administered in early 2008 to 7,222 caregivers of children under five selected through multi-stage probability sampling design. Fisher's exact test of association was used to investigate any possible relationship between use of WaterGuard and evidence of diarrhoea. A mutilvariate logistic regression was also used to specially explore the impact of WaterGuard.

Results: Incidence of diarrhea was 12.6% in urban areas and 16.1% in rural areas. Only 39.1% of caregivers do something to improve the quality of their water. A significant association between use of Waterguard and a reduction in diarrhoea episodes was found (p<0.043). . Households that used Waterguard are 0.6 times as likely to have evidence of diarrhoea (p< 0.039, 95% CI: 0.41 to 0.97).

Discussion: WaterGuard was shown to be effective in preventing diarrhoea and is the most commonly, readily available and affordable point of use water treatment in Nigeria. This suggests that WaterGuard communication campaigns should be scaled up, particularly in rural areas.