Effectiveness of Point-of-use Water Treatment Technologies to Prevent Stunting Among Children in South Africa
Effectiveness of Low-cost Point-of-use Water Treatment Technologies to Prevent Stunting Among Children in Limpopo, South Africa
1 other identifier
interventional
415
1 country
1
Brief Summary
This project is a community-based randomized controlled trial designed to test the effectiveness of two point-of-use water treatment technologies to improve clean drinking water access, reduce enteropathogen burden, and improve child growth among children in Limpopo, South Africa.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jun 2016
Longer than P75 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
June 1, 2016
CompletedFirst Submitted
Initial submission to the registry
January 3, 2017
CompletedFirst Posted
Study publicly available on registry
January 6, 2017
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 1, 2018
CompletedStudy Completion
Last participant's last visit for all outcomes
December 1, 2020
CompletedJuly 15, 2025
July 1, 2025
2.5 years
January 3, 2017
July 10, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Change in height-for-age z-score (ΔHAZ)
Height measured quarterly among all children under age 15 in the households, z-scores calculated from World Health Organization growth standards
From 0-2 years of follow-up
Secondary Outcomes (5)
Change in weight-for-age z-score (ΔWAZ)
From 0-2 years of follow-up
Pathogen burden in stool samples
Quarterly from 0-2 years of follow-up
Prevalence of diarrhea
Quarterly from 0-2 years of follow-up
Cognitive function - Bayley Scales of Infant Development III (ages 2-3); Wechsler Preschool and Primary Scale of Intelligence III (ages 3-6); Raven's Combined Matrices (ages > 6)
2, 5, and 7 years of follow-up
Silver levels in treated water samples
Quarterly from 0-2 years of follow-up
Study Arms (4)
MadiDrop (ceramic tablet)
EXPERIMENTALHouseholds receive a MadiDrop (silver-impregnated ceramic tablet) in a safe-storage water container to use for all drinking water needs in the household. MadiDrops are replaced every 6 months over the 2-year intervention study period. In July 2017, all households in the MadiDrop arm were crossed over to the ceramic water filter arm due to inconsistent silver release from the ceramic tablets.
Silver-impregnated ceramic water filter
ACTIVE COMPARATORHouseholds receive a silver-impregnated ceramic filter in a safe-storage water container to use for all drinking water needs in the household. Filters are replaced at the end of the 2-year intervention study period. In December 2017, all silver-impregnated ceramic water filters were replaced with the same ceramic filters without silver due to continued inconsistencies with silver release.
Safe-storage water container
ACTIVE COMPARATORHouseholds receive a safe-storage water container alone to use for all drinking water needs in the household.
No intervention
NO INTERVENTIONHouseholds are encouraged to continue their usual water treatment practices.
Interventions
A silver-impregnated ceramic disk used for drinking water treatment that was developed by engineers at the University of Virginia. When the ceramic disk is placed in a household water storage container, silver diffuses through the porous ceramic into the water at a release rate that is effective for continual disinfection of waterborne pathogens while remaining below the silver drinking water standard. The disk is effective for daily treatment of 10 to 15 liters for at least six months. This intervention was removed from the study in July 2017 (approximately at 1 year of follow-up).
Silver-impregnated ceramic water filter are well-developed, tested, and widely-used devices. In addition to mechanically removing pathogens, the filter is treated with silver to reduce live pathogens that pass through the filter and to provide residual disinfectant to reduce risk of recontamination after treatment. This intervention was replaced with ceramic filters without silver in Dec 2017 (approximately at 1.5 years of follow-up).
The safe-storage water containers used in this study are plastic buckets with a spigot, purchased locally.
Eligibility Criteria
You may qualify if:
- Mother is in third trimester of pregnancy or there is at least one child under 3 years of age in the household
- The child's caregiver is at least 16 years of age
You may not qualify if:
- The household has chlorinated water piped into the home or routinely delivered (via truck or diversion) to a permanent, engineered system that stores the water within the property
- The household currently uses a ceramic filter or other commercial water treatment technology (including a permanent, engineered system that treats the water through filtration and/or chlorination)
- The household has plans to move outside the community in the next 6 months
- The youngest child under 3 years of age is seriously ill (has a severe disease requiring prolonged hospitalization or a severe or chronic condition diagnosed by medical doctor, e.g. neonatal disease, renal disease, chronic heart failure, liver disease, cystic fibrosis, congenital conditions)
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of Virginialead
- University of Vendacollaborator
Study Sites (1)
University of Venda
Thohoyandou, Limpopo, 0950, South Africa
Related Links
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Pascal O Bessong, PhD
University of Venda, Limpopo, South Africa
- PRINCIPAL INVESTIGATOR
Rebecca Dillingham, MD, MPH
University of Virginia
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
January 3, 2017
First Posted
January 6, 2017
Study Start
June 1, 2016
Primary Completion
December 1, 2018
Study Completion
December 1, 2020
Last Updated
July 15, 2025
Record last verified: 2025-07