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EFFECT OF CHLORINATION ON DIARRHEA AMONG CHILDREN UNDER THE AGE OF FIVE YEARS IN RURAL DIRE DAWA, EASTERN ETHIOPIA: A CLUSTER RANDOMIZED CONTROLLED TRIAL
Abstract
Background
Background: Diarrhea disease is a leading cause of child mortality and morbidity in the world. The effect of point-of-use (POU) water treatment in improving the quality of water in areas where POU is not provided free of charge were not studied.
Aims
The objective of this study was to evaluate the effectiveness of drinking water disinfection by chlorination in diarrhea disease reduction among children under the age of five years in rural eastern Ethiopia.
Methods
We carried out a cluster randomized controlled trial in rural Dire Dawa between October 2018 and January 2019. The 405 households were randomized to intervention and control arms and intervention materials were distributed after conducting the baseline survey. Intervention households received 1.25% sodium hypochlorite with demonstration. Participants in the control households were allowed to continue with their usual habits of water collection and water storage. Generalized estimation equation (GEE) was used to compute adjusted incidence rate ratio and the corresponding 95% confidence intervals.
Results
In the intervention households, a total of 281 cases of diarrhea were documented, but in the control households a total of 446 cases of diarrhea were documented. A 36% (adjusted IRR = 0.64, 95% CI 0.57 – 0.73) reduction in incidence of diarrhea was observed in the intervention arm when compared with the control arm.
Conclusions
Chlorinating drinking water at the household level may be a valuable interim solution until potable water is made accessible to the majority of the populations in Dire Dawa Administration and other Ethiopian communities.