Water-Related Diseases

The goals of this clinical trial are to: 1. gather preliminary data on the effectiveness of a table-top water pitcher filtration system in reducing arsenic exposure among individuals using private wells with elevated (\>5 μg/L) arsenic concentrations, and 2. identify the factors influencing implementation of the filter intervention (uptake and sustainability) and barriers and facilitators to its use. The main questions it aims to answer are: Do water and urinary arsenic concentrations change from baseline to Week 4 of the water pitcher intervention? Are changes in arsenic concentrations maintained during the eight-week sustainability period? * Which factors facilitate or impede uptake, use, and sustainability of the intervention? * Are household income and/or home ownership associated with sustained filter use? Participants will: * Receive a free 12-cup water filter pitcher and cartridge replacements * Use the pitcher filtration system, including replacement of filter cartridges, per manufacturer recommendations * Collect and mail water and urine samples at baseline, 4 weeks, and 12 weeks * Complete online questionnaires at baseline, 4 weeks, and 12 weeks

The first objective of our study is to develop a theory-driven evidence-based targeted water, sanitation, and hygiene (WASH) intervention for household members of diarrhea patients in South Kivu, Democratic Republic of the Congo (DRC) through formative research and community engagement. The second objective is to conduct a randomized controlled trial of 2,320 household members of 580 severe diarrhea patients to evaluate the effectiveness of the developed targeted WASH intervention in terms of: 1. reducing diarrheal diseases household members of cholera and severe diarrhea patients; and 2. increasing WASH behaviors.

Guaranteeing access to safe drinking water is still a challenge in rural households in developing countries, and unsafe water sources are responsible for millions of deaths each year around the world. Coupons for free dilute chlorine solution are a cost-effective and effective way of ameliorating child health and reducing diarrhea incidence. It is still an empirical challenge, however, to see if the positive health effects will be maintained when the program is implemented at scale. In this study, investigators conduct a randomized controlled trial (RCT) at scale to study the impacts of a chlorine coupon program implemented at health clinics on child health, including self-reported diarrhea, fever, and cough incidence in the previous two weeks. Investigators further investigate the pathway of the impact, such as self-reported and objectively measured use of chlorine and frequency of visits to health clinics.