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HOUSEHOLD WATER TREATMENT USING SODIUM DICHLOROISOCY ANURATE (NaDCC) TABLETS: A RANDOMIZED, CONTROLLED TRIAL TO ASSESS MICROBIOLOGICAL EFFECTIVENESS IN BANGLADESH

We assessed the microbiologic effectiveness of sodium dichloroisocyanurate (NaDCC) tablets used on a routine basis at the household level by a vulnerable population. In a 4-month trial in Dhaka, Bangladesh, one half of the 100 participating households received NaDCC tablets and instructions on how to use the same; the other one half received a placebo and the same instructions. Monthly samples of stored drinking water from intervention households were significantly lower in thermotolerant coliforms (TTCs) than those of control households (geometric mean, 2.8 [95% CI: 2.2, 3.6] versus 604.1 [95% CI: 463.2, 787.9]; P < 0.0001). While 61.7% (116/188) of samples from the intervention households met World Health Organization (WHO) guidelines for 0 TTCs in drinking water, none of the 191 samples from control households met such a benchmark. Residual free chlorine in water samples suggested that householders consistently used the intervention, but 11.7% of samples exceeded the WHO guideline value of 5.0 mg/L, underscoring the need to ensure that tablet dose and vessel size are compatible.

Received July 21, 2006. Accepted for publication September 6, 2006.

Acknowledgments: The authors thank the residents of the Geneva camp who generously participated in this study and Dushtha Shasthya Kendra, Neelima Afroz Molla, and Dr Akram Hossain for assistance.

Disclosure: T. Clasen provides consulting services to Medentech, a manufacturer of NaDCC tablets. P. Edmonson is technical director at Medentech. These statements are made in the interest of full disclosure and not because the authors consider this to be a conflict of interest.

Financial support: Medentech, a manufacturer of NaDCC tablets, donated the tablets and placebos used in this trial and covered the cost of consumables used in the water analyses.

^* Address correspondence to Thomas Clasen, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail: thomas.clasen{at}lshtm.ac.uk

Authors’ addresses: Thomas Clasen, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK, E-mail: thomas.clasen{at}lshtm.ac.uk. Tanveer F. Saeed, School of Environment, Resources and Development, Asian Institute of Technology, PO Box 4, Klong Luang, Pathumthani 12120, Thailand, E-mail: onindo26{at}yahoo.com. Sophie Boisson, International Health Research Associates, 2501 E. Beverly Road, Milwaukee, WI 53211, E-mail: sophie.boisson{at}gmail.com. Paul Edmondson, Medentech, Whitemill Industrial Estate, Clonard Road, Wexford, Ireland, E-mail: pedmondson{at}medentech.com. Oleg V. Shipin, School of Environment, Resources and Development, Asian Institute of Technology, PO Box 4, Klong Luang, Pathumthani 12120, Thailand, E-mail: oshipin{at}ait.ac.th.