From Kentucky to Kenya: How International Students Returned Home and Quantified Health Benefits Associated with Water Disinfection Strategies (20m Lecture))

Many international students come to the U.S. to obtain an education that will enable them to assist in addressing the most significant challenges in their native lands. In many cases, these international students possess talents underutilized by mentors who may have interest in international environmental health. Some students come to EHS programs concerned about waterborne diseases, a leading cause of death worldwide, and in these situations, numerous research opportunities are available using simple field-based survey methods and microbiological techniques. Given that few epidemiological studies have evaluated any of the rapidly expanding household disinfection strategies being implemented all over the world, student-collected results can be very beneficial. In our study, we used a 28-day retrospective design to ascertain disease prevalence and water disinfection practices in Kenya’s Great Rift Valley. Logistic regression models were constructed to estimate human health benefits related to treated water access and differing water disinfection techniques. Using a survey administered orally in the native language of the two students (Swahili and Kalenjin), we obtained health and exposure data from 159 households representing 846 individuals in January 2013. Multivariable logistic regression (adjusting for age, gender, and belief in water treatment) demonstrated decreased odds of vomiting (odds ratio = 0.40; 95% confidence interval (CI): 0.19 – 0.85), sore throat (OR = 0.55; CI 0.31 – 0.98), nausea (OR = 0.40; CI = 0.17 – 0.94), and fever (OR = 0.47; CI = 0.22 – 0.98) among those drinking publically treated water compared to those drinking untreated water. Among those without treatment, their odds of vomiting decreased when water was filtered (OR = 0.24; CI 0.09 – 0.66), and when two or more home treatment methods were used (OR = 0.20; CI 0.06 – 0.72) compared to those drinking untreated water. Increasing E. coli densities were associated with increasing odds of diarrhea (OR = 1.5; CI 1.0- 2.0), but not vomiting. This study demonstrates international students can collect awesome data and multiple household treatment methods likely reduce human illness.