The Long-Term Impact of Water and Sanitation on Childhood Cognition. The FASEB Journal, April 2015.
Authors: Nisaa’ Wulan, Emily Smith, et al.
Unsafe water and poor sanitation may negatively affect brain development, however few studies have examined the long-term impact on children’s cognitive function. Our objective was to assess the relationship between household access to safe water and toilet facilities during the prenatal period with childhood cognition 9-12 years later. The Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT), conducted in 2001-2004 In Indonesia, compared the health effects of a prenatal multiple micronutrient supplement to an iron and folic acid supplement.
Children of mothers who had access to safe toilet facilities during pregnancy had higher scores in Digit Span Forward (95%CI 0.008-0.17, P<0.03), Information (95%CI 0.08-0.2, P<0.001), Block Design (95%CI 0.01-0.1, P<0.02), and Word List Memory (95%CI 0.006-0.17, P<0.03) tests after adjusting for cluster randomization, data collector, maternal education, socio-economic status and home environment score.
Children of mothers with access to safe water during pregnancy had higher Word List Memory scores (95%CI 0.01-0.19, P<0.02). The finding that safe water and toilet facilities were associated with child cognition even after adjustment for socio-economic status and maternal education suggests that interventions to improve water and sanitation in early life may have long-term benefits on child cognitive abilities.