Effectiveness of home water treatment for the control of diarrhea in children under five years: an intervention study in a rural health zone of Tshopo in the Democratic Republic of Congo

ABSTRACT Villages that were once certified as ‘sanitized’ have lost their status and now have high rates of diarrheal diseases. The goal of this study was to evaluate the effectiveness of water treatment and safe management in reducing diarrheal diseases in children aged 0–59 months. An intervention study with non-randomized allocation of subjects was conducted from 1 September 2023 to 29 February 2024 in two villages in Tshopo province. The control village was the one selected in the similar context in terms of water supply, hygiene and sanitation. The incidence of diarrhea was calculated in each village per 100 person-weeks. Systematic water treatment combined with hygienic storage and reduction of storage time to 24 h reduced the prevalence of diarrhea from 49.6 to 9% in children aged 0–59 months. Village category (IRR = 1.89, 95% CI: 1.8–1.98), education level (IRR = 1.101, 95% CI: 1.05–1.5), marital status of household head (IRR = 1.13, 95% CI: 1.02–1.24) and household size (IRR = 1.08, 95% CI: 1.07–1.08) were associated with diarrhea. Water treatment and safe management are effective measures to reduce diarrheal morbidity and should be recommended in the context of poor household access to improved water sources.