Evaluating In-line Chlorination in Nigeria

Официальное название

In-line Chlorination for Drinking Water Treatment in Nigeria

Обзор

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.

Вмешательства

• Устройство 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

Первичные конечные точки

• Proportion of water source samples with detectable free chlorine residual. [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Proportion of household stored drinking water samples with detectable free chlorine residual. [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Proportion of household stored drinking water samples positive for Escherichia coli. [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]

Вторичные конечные точки (8)

• Proportion of water source samples with detectable total chlorine residual. [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Concentration of E. coli in water source samples [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Concentration of E. coli in household stored water samples [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Concentration of total coliform bacteria in water source samples [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Concentration of total coliform bacteria in household stored water samples [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Prevalence of caregiver-reported diarrhea among children under five years of age [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Prevalence of caregiver-reported diarrhea among household members, any age [Срок оценки: About 4-, 8-, and 12-month follow ups after device installations]
• Prevalence of diarrhea among female caregivers [Срок оценки: Time frame - About 4-, 8-, and 12-month follow ups after device installations]

Критерии участия

Критерии включения

• 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

Критерии исключения

• Non-age-eligible women. Men and non-emancipated minors. Women who do not consent.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Профилактика

Центры проведения

Nigeria · 2 центра

• Yala LGA — Yala
• Makoda LGA — Makuda

Публикации

• 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

Идентификаторы

NCT: NCT07601503 · 2025-08-18832

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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