Impact of Water-Vending Kiosks and Hygiene Education on Household Drinking Water Quality in Rural Ghana

Melissa C. Opryszko Departments of Environmental Health Sciences and Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Geography and Environmental Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland

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Yayi Guo Departments of Environmental Health Sciences and Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Geography and Environmental Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland

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Luke MacDonald Departments of Environmental Health Sciences and Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Geography and Environmental Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland

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Laura MacDonald Departments of Environmental Health Sciences and Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Geography and Environmental Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland

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Samara Kiihl Departments of Environmental Health Sciences and Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Geography and Environmental Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland

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Kellogg J. Schwab Departments of Environmental Health Sciences and Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Geography and Environmental Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland

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Innovative solutions are essential to improving global access to potable water for nearly 1 billion people. This study presents an independent investigation of one alternative by examining for-profit water-vending kiosks, WaterHealth Centers (WHCs), in rural Ghana to determine their association with household drinking water quality. WHCs' design includes surface water treatment using filtration and ultraviolet light disinfection along with community-based hygiene education. Analyses of water samples for Escherichia coli and household surveys from 49 households across five villages collected one time per year for 3 years indicate that households using WHCs had improved water quality compared with households using untreated surface water (adjusted incidence rate ratio = 0.07, 95% confidence interval = 0.02, 0.21). However, only 38% of households used WHCs by the third year, and 60% of those households had E. coli in their water. Recontamination during water transport and storage is an obstacle to maintaining WHC-vended water quality.

Author Notes

* Address correspondence to Kellogg J. Schwab, 615 N. Wolfe St., Room E6620, Baltimore, MD 21205. E-mail: kschwab@jhsph.edu

Financial support: This study was supported by the Hopkins Sommer Scholars Program of the Johns Hopkins Bloomberg School of Public Health, the Osprey Foundation of Maryland, the Johns Hopkins University Global Water Program, and the Johns Hopkins University Center for Water and Health.

Authors' addresses: Melissa C. Opryszko, Yayi Guo, Luke MacDonald, and Kellogg J. Schwab, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, E-mails: mopryszk@jhsph.edu, yguo@jhsph.edu, lmacdona@jhsph.edu, and kschwab@jhsph.edu. Laura MacDonald, Department of Geography and Environmental Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, E-mail: laura.macdonald@jhu.edu. Samara Kiihl, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, E-mail: sfkiihl@jhsph.edu.

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