Evaluating the efficacy of point-of-use water filtration units in Fiji

BACKGROUND: To develop and evaluate a strategy for reducing the prevalence and impact of waterborne disease, a water quality intervention was developed for Fiji by Give Clean Water, Inc. in partnership with the Fiji Ministry of Health. Residents were provided and trained on how to use a Sawyer® PointONE™ filter, while also being taught proper handwashing techniques. At the time of the filter installation, all households were surveyed inquiring about the prior 2- to 4-week period. Households were measured a second time between 19 and 225 days later (mean = 66 days). RESULTS: To date, five economic and health outcomes have been tracked on 503 households to evaluate the efficacy of the intervention. When comparing baseline to follow-up among the 503 households, the 2-week diarrhea prevalence decreased in households from 17.5% at baseline to 1.8% at follow-up. Also, the 2-week prevalence of severe diarrhea decreased per household from 9.7% at baseline to 0.6% at follow-up. Finally, monthly diarrhea-related medical costs reduced by an average of Fijian (FJ) $3.54 per person, and monthly water expenses reduced by FJ $0.63 per person. All estimated values are obtained from general linear and logistic mixed-effect models, which adjusted for location, season, time to follow-up, household size, water source, and respondent changing. Changes in economic and health outcomes from installation to follow-up were statistically significant (p < 0.05) in all cases, in both unadjusted and adjusted models. CONCLUSIONS: The installation of water filters shows promise for the reduction of diarrhea prevalence in Fiji, as well as the reduction of diarrhea-related medical costs and water expenses. Future work entails evaluation in other countries and contexts, long-term health monitoring, and comparison to alternative water quality interventions.