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Am. J. Trop. Med. Hyg., 70(6), 2004, pp. 651-657
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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REDUCING DIARRHEA THROUGH THE USE OF HOUSEHOLD-BASED CERAMIC WATER FILTERS: A RANDOMIZED, CONTROLLED TRIAL IN RURAL BOLIVIA

THOMAS F. CLASEN, JOSEPH BROWN, SIMON COLLIN, OSCAR SUNTURA, AND SANDY CAIRNCROSS
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina; First Water, Ltd., Bristol, United Kingdom; Fundación Sumaj Huasi, La Paz, Bolivia

Ceramic water filters have been identified as one of the most promising and accessible technologies for treating water at the household level. In a six-month trial, water filters were distributed randomly to half of the 50 participating households in a rural community in Bolivia; the remaining households continued to use customary water handling practices and served as controls. In four rounds of sampling following distribution of the filters, 100% of the 96 water samples from the filter households were free of thermotolerant coliforms compared with 15.5% of the control household samples. Diarrheal disease risk for individuals in intervention households was 70% lower than for controls (95% confidence interval [CI] = 53–80%; P < 0.001). For children less than five years old, the reduction in risk was 83% (95% CI = 51–94%; P < 0.001). These results show that affordable ceramic water filters enable low-income households to treat and maintain the microbiologic quality of their drinking water.


Received December 8, 2003. Accepted for publication February 23, 2004.

Acknowledgments: We express our gratitude to the community of Charinco for participating in this study. We are also grateful to Linda Venczel and Diego Daza (Pan American Health Organization, La Paz, Bolivia); Simon Cousens (London School of Hygiene and Tropical Medicine); and Eric Mintz, Rob Quick, and Jon Macy (Centers for Disease Control and Prevention, Atlanta, GA) for their assistance with this study.

Financial support: This study was supported by First Water, Ltd., The Gates Cambridge Trust, and Trinity Hall, University of Cambridge, United Kingdom.

Disclosure: Thomas F. Clasen is president and an employee of First Water, Ltd., which designs, evaluates, and sells point-of-use water treatment products, including ceramic filters. Simon Collin is paid by First Water, Ltd. to develop and supply household water treatment products, including ceramic filters. These statements are made in the interest of full disclosure and not because the authors consider this to be a conflict of interest.

Authors’ addresses: Thomas F. Clasen and Sandy Cairncross, Disease Control and Vector Biology Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom, Telephone: 44-20-7636-8636, Fax: 44-20-7436-5389, E-mails: thomas.clasen{at}lshtm.ac.uk and sandy.cairncross{at}lshtm.ac.uk. Joseph Brown, Department of Environmental Sciences and Engineering, University of North Carolina, Rosenau Hall, CB# 7431 Chapel Hill, NC 27599-7431, Telephone: 919-966-2488, Fax: 919-966-7911, E-mail: joebrown{at}email.unc.edu. Simon Collin, First Water, Unit 62, Spike Island, 133 Cumberland Road, Bristol, BS1 6UX, United Kingdom, Telephone: 44-117-922-5950, Fax: 44-117-929-2066, E-mail: simon{at}firstwater.info.




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