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Trop Med Health. 2019 Aug 7;47:48. doi: 10.1186/s41182-019-0175-4. eCollection 2019.

Evaluating the efficacy of point-of-use water filtration units in Fiji.

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Department of Mathematics and Statistics, Dordt University, 498 4th Ave NE, Sioux Center, IA 51250 USA.
2Department of Statistics, Montana State University, Bozeman, MT USA.
3Department of Biology, Hope College, Holland, MI USA.



To develop and evaluate a strategy for reducing the prevalence and impact of waterborne disease, a water quality intervention was developed for Fiji by Give Clean Water, Inc. in partnership with the Fiji Ministry of Health. Residents were provided and trained on how to use a Sawyer® PointONE™ filter, while also being taught proper handwashing techniques. At the time of the filter installation, all households were surveyed inquiring about the prior 2- to 4-week period. Households were measured a second time between 19 and 225 days later (mean = 66 days).


To date, five economic and health outcomes have been tracked on 503 households to evaluate the efficacy of the intervention. When comparing baseline to follow-up among the 503 households, the 2-week diarrhea prevalence decreased in households from 17.5% at baseline to 1.8% at follow-up. Also, the 2-week prevalence of severe diarrhea decreased per household from 9.7% at baseline to 0.6% at follow-up. Finally, monthly diarrhea-related medical costs reduced by an average of Fijian (FJ) $3.54 per person, and monthly water expenses reduced by FJ $0.63 per person. All estimated values are obtained from general linear and logistic mixed-effect models, which adjusted for location, season, time to follow-up, household size, water source, and respondent changing. Changes in economic and health outcomes from installation to follow-up were statistically significant (p < 0.05) in all cases, in both unadjusted and adjusted models.


The installation of water filters shows promise for the reduction of diarrhea prevalence in Fiji, as well as the reduction of diarrhea-related medical costs and water expenses. Future work entails evaluation in other countries and contexts, long-term health monitoring, and comparison to alternative water quality interventions.


Diarrhea; Fiji; Filtration; Low- and middle-income country; Water treatment

Conflict of interest statement

Competing interestsPortions of the authors’ time were supported by a grant from Sawyer Products Inc.

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