The effects of informational interventions on household water management, hygiene behaviors, stored drinking water quality, and hand contamination in peri-urban Tanzania

Abstract

Safe water storage and hand hygiene have been shown to reduce fecal contamination and improve health in experimental settings; however, triggering and sustaining such behaviors is challenging. This study investigates the extent to which personalized information about Escherichia coli contamination of stored water and hands influenced knowledge, reported behaviors, and subsequent contamination levels among 334 households with less than 5-year-old children in peri-urban Dar es Salaam, Tanzania. One-quarter of the study participants received information about strategies to reduce risk of water- and sanitation-related illness. Respondents in another three study cohorts received this same information, along with their household's water and/or hand-rinse test results. Findings from this study suggest that additional work is needed to elucidate the conditions under which such testing represents a cost-effective strategy to motivate improved household water management and hand hygiene.

Figure 1.

Change in estimated marginal mean concentration log-transformed E. coli (log CFU/100 mL) in stored drinking water by cohort and study phase. Negative values indicate a reduction in contamination.

Figure 2.

Change in estimated marginal mean concentration of log-transformed E. coli (log CFU/2 hands) on mothers' hands by cohort and study phase. Negative values indicate a reduction in contamination.