The Impact of Point-of-Use Water Treatment Interventions on WPPSI-III Cognitive Scores among Children 5 years and younger in Limpopo, South Africa Restricted; Files Only
Gaylord, Amanda (Spring 2023)
Published
Abstract
For children in low-resource settings, repeated exposure to enteric pathogens can have drastic long-term effects. Early childhood enteropathogenic infections are potentially associated with impaired cognitive development. This project examines the relationship between cognitive function and access to effective, low-cost, point-of-use (POU) water treatment technologies. A community-based randomized controlled trial of two POU water treatment technologies was conducted in Limpopo, South Africa. The water treatment technologies studied were i) a silver-impregnated ceramic filter, and ii) a silver-impregnated ceramic tablet. In total, 404 households with a primary study child younger than 3 years old were randomized to one of four groups: a) the filter and tablet, b) the tablet only, c) a safe-storage water container, or d) no intervention. Follow-up surveys were done every quarter for the following two years. At approximately 2 years after the baseline assessment, 236 of the primary study children were evaluated using the Wechsler Preschool and Primary Scale of Intelligence – Third Edition (WPPSI-III) examination to estimate the effects of the POU water treatment technologies on cognitive function. It was found that there was no significant difference in WPPSI-III examination composite scores between intervention groups, after controlling for covariates. It was also found that the individual presence of enteric pathogens at enrollment, reported diarrhea, and water service level had no effect on WPPSI-III z-scores after controlling for covariates. However, sociodemographic variables (socioeconomic score, crowding, village, and caregiver handwashing habits) were significant predictors of cognitive function within the study population. These results are consistent with the lack of significant effects of the intervention group on proximal outcomes such as enteric infections, diarrhea, and growth stunting for the same study population that have been described previously.
Table of Contents
Introduction.......................................page 1
Methods.............................................page 7
Study Design....................................page 7
Cognitive output data collection........page 8
Outcome definitions.........................page 9
Data analysis...................................page 10
Results..............................................page 12
Baseline assessment........................page 12
Follow-up assessments....................page 13
Cognitive outcomes.........................page 17
Discussion........................................page 22
References........................................page 26
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File download under embargo until 18 May 2025 | 2023-04-19 14:01:47 -0400 | File download under embargo until 18 May 2025 |
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