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In an earlier study in rural Guatemala, 257 households that received flocculant-disinfectant to treat their drinking water had 39% less diarrhea than 257 control households. Three weeks after completion of the study, national marketing of the flocculant-disinfectant was extended into the study communities. Six months later, we assessed frequency of and characteristics associated with purchase and use of the flocculant-disinfectant by revisiting the original study households and administering a questionnaire. Four hundred sixty-two households (90%) completed the follow-up survey; 22 households (5%) purchased the flocculant-disinfectant within the preceding 2 weeks and used it within the last week. Neither being randomized to the intervention group during the efficacy study nor combined spending on laundry soap, toothpaste, and hand soap in the preceding week was associated with active repeat use. Even after efficacy was demonstrated within their community and an aggressive sophisticated marketing approach, few households purchased flocculant-disinfectant for point-of-use water treatment.
Received September 1, 2007. Accepted for publication November 16, 2007.
Acknowledgments: The authors thank Rudinio Acevedo, Medical Entomology Research and Training Unit, for assistance with data management, our team of field workers for careful collection of data, and Rob Quick, Centers for Disease Control and Prevention, for useful comments on earlier drafts.
Financial support: The bulk of the funding for this study, including salary support for SPL, was provided by the Procter & Gamble Company through a cooperative research and development agreement between the CDC and Prevention and the Procter & Gamble Company. The remainder of the study funding was provided by the CDC. Employees of the Procter & Gamble Company approved the design of the study, commented on the interpretation of the data, and reviewed the manuscript. They were not involved in the conduct of the study, data collection, project management, or data analysis. As part of the cooperative agreement, the CDC retains the right to publish results without approval from the Procter & Gamble Company.
* Address correspondence to Stephen P. Luby, ICDDR, B GPO Box 128, Dhaka 1000, Bangladesh. E-mail: sluby{at}cdc.gov
Authors’ addresses: Stephen P. Luby, ICDDR, B GPO Box 128, Dhaka 1000, Bangladesh, Tel: 88–02–988–1761, Fax: 88–02–882–3963, E-mail: sluby{at}cdc.gov. Carlos Mendoza, Universidad del Valle de Guatemala, 18 avenida 11–95 zona 14 V.H. III, Guatemala City, Guatemala. Bruce H. Keswick, Procter and Gamble Japan K.K., 17, Koyo-cho Naka 1-chome, Higashinada-ku, Kobe 658–0032, Japan. R. Mike Hoekstra and Tom M. Chiller, Centers for Disease Control and Prevention, Mailstop C09, 1600 Clifton Road, Atlanta, GA 30333.
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