Evaluating In-line Chlorination in Nigeria
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: In-line Chlorination (ILC) with Behavioral Change Communication (BCC).
- Who it may be relevant to
- Registry conditions: Diarrhea, Water Quality, Adoption. Basic parameters: from 15 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Nigeria
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
In-line Chlorination for Drinking Water Treatment in Nigeria
Overview
This study evaluates the implementation and effectiveness of in-line chlorination (ILC) for improving drinking water quality in rural Nigeria. Unsafe drinking water remains a major contributor to diarrheal disease, particularly among children under five. Inline chlorination is a passive water treatment approach that automatically doses chlorine at community water systems without requiring electricity or daily user action. Two cluster randomized controlled trials will be conducted in Kano State (North-West Nigeria) and Cross River State (South-South Nigeria). Communities will be randomized to either receive in-line chlorination installed at eligible communal water systems or serve as controls with no chlorination. The unit of randomization is a community or a cluster of communities that share water system for drinking water. The primary objective is to estimate the causal impact of in-line chlorination on household drinking water quality. Outcomes include the prevalence of Escherichia coli contamination in tap water and stored household water as well as the presence of free chlorine residual. Secondary objectives assess water source usage and adoption of chlorinated sources, as well as reduction in diarrheal disease. Implementation fidelity and operational performance of chlorination devices will also be monitored.
Interventions
- Device In-line Chlorination (ILC) with Behavioral Change Communication (BCC)
In-line chlorination devices will be installed on all compatible communal water systems within treatment communities. Devices automatically dose chlorine proportional to water flow without requiring electricity or daily user input. Technologies will include TuriTap liquid dosers installed at handpumps and CTI-8 tablet dosers installed at tanks or piped systems. Devices will be calibrated and routinely monitored to maintain chlorine residual within recommended ranges. In addition to device instal
Primary outcome measures
- Proportion of water source samples with detectable free chlorine residual. [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Proportion of household stored drinking water samples with detectable free chlorine residual. [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Proportion of household stored drinking water samples positive for Escherichia coli. [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
Secondary outcome measures (8)
- Proportion of water source samples with detectable total chlorine residual. [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Concentration of E. coli in water source samples [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Concentration of E. coli in household stored water samples [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Concentration of total coliform bacteria in water source samples [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Concentration of total coliform bacteria in household stored water samples [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Prevalence of caregiver-reported diarrhea among children under five years of age [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Prevalence of caregiver-reported diarrhea among household members, any age [Time frame: About 4-, 8-, and 12-month follow ups after device installations]
- Prevalence of diarrhea among female caregivers [Time frame: Time frame - About 4-, 8-, and 12-month follow ups after device installations]
Eligibility criteria
Inclusion criteria
- Adult (18+) or emancipated minor (15+) pregnant women and women with children under 5 years old who do not plan to permanently move in the next 12 months.
- Must be knowledgeable about the household's water collection and management practices
Exclusion criteria
- Non-age-eligible women. Men and non-emancipated minors. Women who do not consent.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Prevention
Study locations
Nigeria · 2 centers
- Yala LGA — Yala
- Makoda LGA — Makuda
Publications
- Pickering AJ, Crider Y, Sultana S, Swarthout J, Goddard FG, Anjerul Islam S, Sen S, Ayyagari R, Luby SP. Effect of in-line drinking water chlorination at the point of collection on child diarrhoea in urban Bangladesh: a double-blind, cluster-randomised controlled trial. Lancet Glob Health. 2019 Sep;7(9):e1247-e1256. doi: 10.1016/S2214-109X(19)30315-8. PMID 31402005
- Lindmark M, Cherukumilli K, Crider YS, Marcenac P, Lozier M, Voth-Gaeddert L, Lantagne DS, Mihelcic JR, Zhang QM, Just C, Pickering AJ. Passive In-Line Chlorination for Drinking Water Disinfection: A Critical Review. Environ Sci Technol. 2022 Jul 5;56(13):9164-9181. doi: 10.1021/acs.est.1c08580. Epub 2022 Jun 14. PMID 35700262
Identifiers
NCT: NCT07601503 · 2025-08-18832