Project Lead(s): Jacqueline Thomas
In Tanzania, 9% of all deaths in children under five years are due to diarrhea and only 54% of the population have access to an improved water supply.
Published meta-analysis reviews have shown that household-level water quality interventions (filtration, chemical treatment and boiling) have greater diarrheal disease risk reduction impact, compared to source water quality interventions.
Ceramic filter pots are an affordable water treatment technology that are locally produced in Tanzania. The ceramic membrane, when produced by hand, can vary in material composition and hence not all pots remove bacteria at the desired 2–3 log reduction. Further, the filter pots' ability to remove bacteria can reduce over time.
Ceramic filter pots can be combined with chlorination to provide complete water quality treatment to improve human health.
To demonstrate this, a randomized controlled trial of different household-level treatments was a conducted. A total of 228 households were recruited and treatments were allocated at random, via a lottery system, to one of four arms:
· Standard ceramic filter pot
· Filter pot combined with novel chlorine (WaterGuard) dosing mechanisms
· Chlorination (WaterGuard) only
· Control (no household-level water treatment).
Each household was followed for three months, with visits every two weeks.
The water quality results showed a significant reduction in the quantity of E. coli after using a drinking water treatment. The average amount of E. coli in source water was reduced from 105 cfu.100 mL-1 to <1 cfu.100mL-1.
All treatments performed equally well. However, it was assessed that the filter pot and chlorine combination was the most protective, as there was little opportunity for recontamination.
Over the three-month study, the prevalence of diarrheal diseases dropped from 7.5% in control to 0.7% in the intervention households (a 90% total reduction).
All participants in the study received a filter pot at the conclusion of the research, as reimbursement for their involvement.
The project was also beneficial to the Upendo local women’s pottery group, as 260 ceramic filter pots were purchased at a price of approximately $30.00 each, generating greater profit for the group that allowed for expansion of their activities.
The team intends to apply for Transition To Scale Phase II funding and their aim is to support the production of the ceramic filters to a commercial quality for direct sale to households, in combination with WaterGuard.
The up-scale model will be via a commercial business model, as there is already sufficient demand for the product in the community. Ifakara Health Institute would assist the commercial partner in research and development.
A large (>500 household) randomized controlled trial will be conducted to demonstrate the health impacts in an urban setting.
The Ministry of Water and Ministry of Health are very supportive of household-level water treatment, due to a current cholera outbreak and ongoing diarrheal disease issues.
Co-funding will be acquired from a private ceramic business investment (Nabaki Afrika), government funds for cholera response and also contributions from NGOs such as PSI (producer of WaterGuard).
For the up-scaling replication, it is estimated that each plant would need a total investment of $400,000 over two years.