Factors predicting compliance, improved water quality, and lower prevalence of diarrhoea: A secondary analysis of a 2008 Aquatab trial in Orissa, India. Open Access

Brooks, Patrick (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/cf95jc03r?locale=en
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Abstract

Background: Disinfection of drinking water through chlorination and safe storage within a household can reduce microbiological contamination, and reduce the morbidity of and mortality resulting from diarrheal disease in <5 children. Historically, interventions targeted at household water treatment and storage (HWTS) have shown mixed results, and have been plagued by issues with compliance, reduction of microbiological organisms in water, and limited impact on health outcomes of interest. In 2010, Boisson et al. conducted a randomized controlled trial of an HWTS intervention in Orissa, India with the goal of assessing the effect of in-home water chlorination on diarrhea in <5 children. We conducted a secondary analysis of data from the trial to identify factors associated with compliance, improved microbiological quality of drinking water, and reduced diarrhea prevalence in <5 children.

Methods: Multilevel linear and logistic regression techniques were applied to data from the cohort of individuals in the intervention arm of the Orissa trial. Data on household- and individual-level indicators were used to build models predicting compliance, improved microbiological quality of drinking water, and diarrhea in <5 children.

Results: 1080 households and 76,036 data points for <5 children were included in the final analysis, and three separate models were run to determine the significance of household- and individual- level factors in predicting outcomes of interest. Compliance was significantly associated with caregiver education (p=0.001), caste of the household (p=0.001), number of individuals per household (p=0.012) and latrine use compliance (p=0.003). Improved microbial quality of water was also significantly predicted by the number of individuals per household (p=0.001). Only age of child was a significant predictor of diarrhea in <5 children (p<0.001).

Conclusions: In order to work towards better health outcomes reliant upon compliance, improved water quality, and reduced diarrhea, future research should focus on a identifying and measuring behavioral, cultural, and environmental barriers and risk factors.

Table of Contents

Table of Contents

Introduction..........................................................................................................................1

Background and Literature Review.....................................................................................3 Methods..............................................................................................................................12

Results ...............................................................................................................................18

Discussion .........................................................................................................................23

References..........................................................................................................................27


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