Environmental Exposure Clinical Trial
Official title:
Effectiveness of Low-cost Point-of-use Water Treatment Technologies to Prevent Stunting Among Children in Limpopo, South Africa
This project is a community-based randomized controlled trial designed to test the effectiveness of two point-of-use water treatment technologies to improve clean drinking water access, reduce enteropathogen burden, and improve child growth among children in Limpopo, South Africa.
Lack of access to safe water in low-resource settings likely contributes to stunted growth
early in life, which affects more than a quarter of children under 5 years worldwide.
Point-of-use water treatment technologies have the potential to provide effective and
low-cost solutions to improving quality of drinking water in these settings. One such
technology, a silver-impregnated ceramic disk, continually disinfects water in household
water storage containers by diffusing silver into the water for daily treatment of 10 to 15
liters for at least six months. Silver-impregnated ceramic water filters are another
commercially available technology that additionally remove pathogens mechanically. While both
technologies have proven to be highly effective in treating water, it is unknown whether the
use of these technologies will translate to improvements in child health outcomes. This
community-based intervention trial will estimate the effect of the silver-impregnated ceramic
disk and a silver-impregnated ceramic water filter on linear growth of children in Limpopo,
South Africa.
Households in the Dzimauli community will be randomized to receive the ceramic disk, a water
filter, the safe-storage water container alone, or no intervention. Children will be followed
every three months for 2 years to assess height, weight, and pathogen burden in stool
samples. Cognitive assessments will be completed at 2, 5, and 7 years of follow-up. The
investigators hypothesize that children in households given the ceramic disk or the water
filter will show improved linear growth compared to those in households without these
interventions. The investigators expect that the ceramic disk will perform similarly to the
water filter and result in similar improvements in linear growth when compared to children
from control households.
Estimates of effectiveness demonstrated in this trial will provide the necessary evidence
base to support the scale-up of manufacturing and distribution of the ceramic disks and
filters, which could provide a robust point-of-use water treatment solution for rural areas.
By helping to identify effective tools to reduce the risk of stunting in children, the trial
will contribute to targets to improve child health in low-resource settings.
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