Volume 94, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



In the developing world, fetching water for drinking and other household uses is a substantial burden that affects water quantity and quality in the household. We used logistic regression to examine whether reported household water fetching times were a risk factor for moderate-to-severe diarrhea (MSD) using case–control data of 3,359 households from the Global Enterics Multi-Center Study in Kenya in 2009–2011. We collected additional global positioning system (GPS) data for a subset of 254 randomly selected households and compared GPS-based straight line and actual travel path distances to fetching times reported by respondents. GPS-based data were highly correlated with respondent-provided times (Spearman correlation coefficient = 0.81, < 0.0001). The median estimated one-way distance to water source was 200 m for cases and 171 for controls (Wilcoxon rank sums/Mann–Whitney = 0.21). A round-trip fetching time of > 30 minutes was reported by 25% of cases versus 15% of controls and was significantly associated with MSD where rainwater was not used in the last 2 weeks (odds ratio = 1.97, 95% confidence interval = 1.56–2.49). These data support the United Nations definition of access to an improved water source being within 30 minutes total round-trip travel time.


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  • Received : 26 May 2015
  • Accepted : 21 Jan 2016

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