Impact evaluation of water supply improvements in Uvira, DRC

Water, Sanitation and Hygiene (WASH) Democratic Republic of Congo completed

Project timeline: 10/10/2016 - 31/07/2022

Lead Researcher

Dr. Karin Gallandat

Organisation / Institution

London School of Hygiene and Tropical Medicine (LSHTM)


AFD - Agence Francaise de Development
Fondation Veolia

Project summary

The cholera burden is concentrated in endemic settings with inadequate water, sanitation and hygiene access. There is limited rigorous evidence for the impact of improved water supply on endemic cholera transmission in low-income urban settings. We propose a pragmatic health impact evaluation of a large-scale water supply intervention in Uvira (South Kivu, Democratic Republic of the Congo), a cholera transmission hotspot. A stepped-wedge cluster randomised trial (SW-CRT) was designed to evaluate the impact of a large-scale drinking water supply intervention on cholera incidence among the 280,000 inhabitants of Uvira. The city was divided into 16 clusters, where new community and household taps will be installed following a randomised sequence over a transition period of up to 8 weeks in each cluster. The primary trial outcomes are the monthly incidence of “confirmed” cholera cases (patients testing positive by rapid detection kit) and of “suspected” cholera cases (patients admitted to the cholera treatment centre). Concurrent process and economic evaluations will provide further information on the context, costs and efficiency of the intervention. Overall, this research has the potential to provide robust evidence to support more effective cholera prevention in challenging, high-burden settings. This trial is registered on (NCT02928341).

Potential for public health impact or global health decision-making

The Uvira research provides a unique opportunity to inform future investments in water supply infrastructure improvements and cholera prevention strategies in endemic transmission hotspots.


Oliver Cumming, London School of Hygiene and Tropical Medicine (LSHTM)
Jaime Mufitini Saidi, Uvira Health Zone

Key Collaborators

OXFAM International
Uvira Health Zone
Ministry of Health

Resources (6)

Clinical Trial ID



The impact of improved water supply on cholera and diarrhoeal diseases in Uvira, Democratic Republic of the Congo: A protocol for a pragmatic stepped-wedge cluster randomised trial and economic evaluation.


Prevalence and diversity of enteric infections among cholera treatment centre patients with acute diarrhea in Uvira, Democratic Republic of Congo


Predicting quality and quantity of water used by urban households based on tap water service.


Confirmation of cholera by rapid diagnostic test amongst patients admitted to the cholera treatment centre in Uvira, Democratic Republic of the Congo.


Water Supply Interruptions and Suspected Cholera Incidence: A Time-Series Regression in the Democratic Republic of the Congo.