Evaluation of consistent use, barriers to use, and microbiological effectiveness of three prototype household water treatment technologies in Haiti, Kenya, and Nicaragua

Evaluation of consistent use, barriers to use, and microbiological effectiveness of three prototype household water treatment technologies in Haiti, Kenya, and Nicaragua

[Display omitted] •Water treatment technologies are insufficiently evaluated in household settings.•We evaluated four technologies for effectiveness and use to inform design decisions.•Each household treatment technology improved microbiological drinking water quality.•Use of household water treatme...

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Bibliographic Details
Published in:The Science of the total environment Vol. 718; p. 134685
Main Authors: Murray, Anna L., Napotnik, Julie A., Rayner, Justine S., Mendoza, Antonia, Mitro, Brittany, Norville, Joshua, Faith, Sitnah H., Eleveld, Alie, Jellison, Kristen L., Lantagne, Daniele S.
Format: Journal Article
Language:English
Published: Netherlands Elsevier B.V 20-05-2020
Subjects:
Biosand filter
Ceramic filter
Drinking Water
Escherichia coli
Field evaluation
Haiti
Kenya
Microbiological effectiveness
Nicaragua
Point-of-use
Water Microbiology
Water Purification
Water treatment
Kenya
Haiti
Nicaragua
Water treatment
Ceramic filter
Biosand filter
Microbiological effectiveness
Point-of-use
Field evaluation
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Summary:[Display omitted] •Water treatment technologies are insufficiently evaluated in household settings.•We evaluated four technologies for effectiveness and use to inform design decisions.•Each household treatment technology improved microbiological drinking water quality.•Use of household water treatment declined over time, and some products failed.•Household evaluations are critical within water treatment product design cycles. Household water treatment (HWT) can improve drinking water quality and reduce diarrheal disease. New HWT technologies are typically evaluated under ideal conditions; however, health gains depend on consistent, effective household use, which is less often evaluated. We conducted four evaluations of three prototype HWT technologies: two filters and one electrochlorinator. Evaluations consisted of a baseline survey, HWT distribution to households (ranging from 60 to 82), and four visits (ranging from 1 week-14 months after distribution). Each visit included a survey, observation of treated water presence (confirmed use), and microbiological analysis of treated and untreated samples for E. coli. Consistent use was defined as the proportion of total visits with confirmed use. Overall, confirmed use declined 2.54% per month on average, and 2–72% of households demonstrated 100% consistent use. Consistent use was positively associated with baseline HWT knowledge and practice and belief that drinking water was unsafe, and negatively associated with technological problems. Reported barriers to use were behavioral, such as forgetting or when outside the home, and technological failures. Technologies demonstrated 68–96% E. coli reductions, with 18–70% of treated samples having detectable E. coli. Results highlight the importance of household use evaluations within prototype HWT technology design cycles, the need for standard evaluation metrics, and difficulties in achieving both consistent use and microbiological effectiveness with HWT technologies.
ISSN:0048-9697
1879-1026
DOI:10.1016/j.scitotenv.2019.134685