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Impact of integrated water, sanitation, hygiene, health and nutritional interventions on diarrhoea disease epidemiology and microbial quality of water in a resource‐constrained setting in Kenya: A controlled intervention study

Title: Impact of integrated water, sanitation, hygiene, health and nutritional interventions on diarrhoea disease epidemiology and microbial quality of water in a resource‐constrained setting in Kenya: A controlled intervention study
Authors: Wandera, Ernest Apondi; Muriithi, Betty; Kathiiko, Cyrus; Mutunga, Felix; Wachira, Mary; Mumo, Maurine; Mwangi, Anne; Tinkoi, Joseph; Meiguran, Mirasine; Akumu, Pius; Ndege, Valeria; Kasiku, Fredrick; Ang'awa, James; Mochizuki, Ryoichiro; Kaneko, Satoshi; Morita, Kouichi; Ouma, Collins; Ichinose, Yoshio
Source: Tropical Medicine & International Health ; volume 27, issue 8, page 669-677 ; ISSN 1360-2276 1365-3156
Publisher Information: Wiley
Publication Year: 2022
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Objectives We assessed the impact of water, hygiene and sanitation (WASH), maternal, new‐born and child health (MNCH), nutrition and early childhood development (ECD) on diarrhoea and microbial quality of water in a resource‐constrained rural setting in Kenya. Methods Through a controlled intervention study, we tested faecal and water samples collected from both the intervention and control sites before and after the interventions using microbiological, immunological and molecular assays to determine the prevalence of diarrhoeagenic agents and microbial quality of water. Data from the hospital registers were used to estimate all‐cause diarrhoea prevalence. Results After the interventions, we observed a 58.2% (95% CI: 39.4–75.3) decline in all‐cause diarrhoea in the intervention site versus a 22.2% (95% CI: 5.9–49.4) reduction of the same in the control site. Besides rotavirus and pathogenic Escherichia coli, the rate of isolation of other diarrhoea‐causing bacteria declined substantially in the intervention site. The microbial quality of community and household water improved considerably in both the intervention (81.9%; 95% CI: 74.5%–87.8%) and control (72.5%; 95% CI: 64.2%–80.5%) sites with the relative improvements in the intervention site being slightly larger. Conclusions The integrated WASH, MNCH, nutrition and ECD interventions resulted in notable decline in all‐cause diarrhoea and improvements in water quality in the rural resource‐limited population in Kenya. This indicates a direct public health impact of the interventions and provides early evidence for public health policy makers to support the sustained implementation of these interventions.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/tmi.13793
Availability: http://dx.doi.org/10.1111/tmi.13793; https://onlinelibrary.wiley.com/doi/pdf/10.1111/tmi.13793; https://onlinelibrary.wiley.com/doi/full-xml/10.1111/tmi.13793
Rights: http://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.9710CD6D
Database: BASE