Can improvements in water supply reduce childhood diarrhoea?

The effects of improving the water supply on the incidence of diarrhoea in 1096 children from three neighbouring villages of the Kirotshe rural health district, Northern Kivu, Zaire were investigated. Two of these villages had piped water, while the third village had no such facility. Children aged under four years on registration were visited fortnightly for one year. Median diarrhoea incidence per two weeks proved to be significanly lower in the two intervention villages than in the control village. In the two intervention villages, median diarrhoea incidence per two weeks was halved in children who lived in households located less than a five-minute walk from the public standpipe, or in households using more than 50 litres of water a day. The association between diarrhoea incidence and facility use did not differ after stratification by socioeconomic variables. These findings underscore the fact that children in households that use standpipes are exposed to a lower risk of diarrhoea. Therefore, it is important to stress that those in charge of the planning and implementation of water supply intervantions investigate the access to, and use of, water amongst the target population.