The assessment on the Lifestraw Personal intervention in Ethiopia has shown a typical response bias for diarrheal disease. What was this bias?

1. The population reported a reduction of diarrheal disease that could not have been achieved with regard to the reported compliance to the HWTS product.

2. The population reported a high use of the HWTS product that was not confirmed by microbiological tests of the water quality.

3. The population reported a low use of the HWTS product that was inconsistent with the good results of water microbiological quality tests. 

4. The population had a fairly high reported use of the HWTS product, but not reduction at all of diarrheal disease, which is impossible.

 

Health impact assessment. Please check all correct statements about the presented reviews on health impact on HWTS.

1. Water quality interventions are associated with a reduction in diarrheal diseases of about 50-60%.

2. The impact on diarrheal diseases was generally found to be higher when the intervention was focused on the household level.

3. The impact on diarrheal diseases was generally found to be higher when the intervention was focused on the source level

 

Researchers have found that in randomized control studies, diarrheal diseases tend to decrease in both the intervention group and the control group over time. What is a possible explanation for that?

1. The Hawthorn effect. Participants in the control groups may adopt safer water and hygiene practices because they are regularly visited into their houses by researchers.

2. The Courtesy effect. Participants in the control group may adopt safer water and hygiene practices because they hope to receive the HWTS product as well.

3. Survey fatigue. Participants and surveyors may become tired of repeatedly completing surveys about disease, and decide to simply report less disease.

4. The Placebo effect. People feel like they are getting some treatment, even when they have received something which should have no impact on water quality.

 

Cost effectiveness. Which two interventions were considered as most cost-effective in the study of Clasen, 2007?

1. Solar disinfection

2. Filtration

3. Flocculation

4. Disinfection

5. Chlorination

 

What is a rule of thumb to assess the cost-effectiveness of public health investments?

1. If the cost to avert one DALY is less than the per capita gross product, it is cost-effective.

2. If the cost to avert one DALY is equal to the average per household income, it is cost-effective.

3. If the cost to avert 1 DALY is equal to the gross domestic product, it is cost-effective.

 

HWTS selection. The Netherlands Water Partnership, in its set of criteria for HWTS, has a category that brings in environmental concerns. What is the name of this category?

1. Green

2. Planet

3. Environmental

4. Ecological

 

Final quiz

Question 1

Which of the following treatment processes is LEAST prone to re-contamination following treatment? Please choose the correct answer.
Chlorine disinfection

Boiling

Ultraviolet treatment

Filtration

Question 2

How many DALYs are lost by a person who has a life expectancy of 74, contracts HIV/AIDS at the age of 40 and lives until the age of 60? This person receives antiretroviral medication two years after she/he contracts HIV/AIDS until she/he dies. [The weighting for HIV/AIDS without antiretroviral medication is 0.5. The weighting for HIV/AIDS with antiretroviral medication is 0.167.] Please enter only the number and rounded to a complete number (no text, no commas, no spaces, no decimal points).
Example for correct answer: 23
Examples for wrong answers: The answer is 23. (Do not include text in the answer.) / 23.1 (Do not include decimals. Round to the nearest integer.)

Question 3

What is the most commonly used faecal indicator bacteria?
Escherichia coli

Rotavirus

Faecal streptococci

Shigella

Question 4

The Global Enteric Multicenter Study (GEMS) was a large study about childhood diarrheal diseases in developing country settings. One of the key findings was that just four pathogens were responsible for the majority of moderate-to-severe diarrhea cases. What are the names of these four pathogens? Please check the four correct answers.
Shigella

Enterobacter

Salmonella

Guinea worm

Cryptosporidium

Rotavirus

Enterotoxigenic E. coli (ETEC)

Poliovirus

Question 5

The Water Safety Framework is made up of 5 distinct components: health based targets, system assessment, operational monitoring, management and communication, and verification. Which three components from this list are included in a Water Safety Plan? Please select the correct answer.
"System assessment", "Operational monitoring", "Management and communication"
"Health based targets", "System assessment", "Operational monitoring"
"Health based targets", "Verification", "System assessment"
"Operational monitoring", "Management and communication", "Verification"

Question 6

A sample of human feces contains 10’000’000 viruses per gram of feces. One gram of this sample is mixed into 1 litre of water and is then exposed to UV-C radiation at a dose of 400 J/m2, reducing the concentration to 1’000 viruses/L. What is the log removal value (LRV) of this UV treatment method? Please select the correct answer.
LRV = 8

LRV = 4

LRV = 2 

LRV = 6

Question 7

What is the most commonly practiced household water treatment practice in the world? Please select the correct answer.
Membrane filtration

UV treatment

Boiling

Chlorine disinfection

Question 8

Solar disinfection (SODIS) relies on ultraviolet light. Which UV-light cannot be used to apply SODIS?

  UV-C

UV-B

UV-A

Question 9

CLARO, WaterGuard, and Sur’Eau are examples of …? Please select the correct answer.
Safe storage devices

Chlorine disinfection products

Water Safety Plans

Behavior change communication strategies

Question 10

The WHO has established a series of health-based microbiological performance targets for household water treatment methods, ranging from an interim target to highly protective. For which pathogen(s) did WHO establish these targets ?
For all 24 pathogens classified in the WHO high-risk category for global burden of disease (e.g., E.coli, Vibrio Cholerae, Ebolavirus, Rotavirus, Giardia, Cryptosporidium)
For E. coli

For Campylobacter jejuni, Rotavirus and Cryptosporidium

Question 11

A household water treatment technology has the following removal efficiencies: Bacteria: 5 LRV; Viruses: 1 LRV; Protozoa: 2 LRV. What class of protection would this be called, using the WHO evaluation criteria?
Limited protection

Highly Protective

Protective

Question 12

Which of the following are study designs that can be used to evaluate the health impacts of household water treatment interventions? Select all that are appropriate.
Case control studies

Cohort studies

Ecological studies

Randomized control trials

 

 

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