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Am. J. Trop. Med. Hyg., 79(5), 2008, pp. 696-701
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Use of Ceramic Water Filtration in the Prevention of Diarrheal Disease: A Randomized Controlled Trial in Rural South Africa and Zimbabwe

Martella du Preez*, Ronán M. Conroy, James A. Wright, Sibonginkosi Moyo, Natasha Potgieter, AND Stephen W. Gundry
Natural Resources and the Environment, CSIR, Pretoria, South Africa; Department of Epidemiology and Preventive Medicine, Royal College of Surgeons in Ireland; Department of Geography, University of Southampton, Southampton, United Kingdom; Research and Technical Services, Institute of Water and Sanitation Development, Harare, Zimbabwe; Natasha Potgieter, Department of Microbiology, University of Venda for Science and Technology, Thohoyandou, Venda, South Africa; Water and Environmental Management Research Centre, University of Bristol, Bristol, United Kingdom

 

ABSTRACT

To determine the effectiveness of ceramic filters in reducing diarrhea, we conducted a randomized controlled trial in Zimbabwe and South Africa, in which 61 of 115 households received ceramic filters. Incidence of non-bloody and bloody diarrhea was recorded daily over 6 months using pictorial diaries for children 24–36 months of age. Poisson regression was used to compare incidence rates in intervention and control households. Adjusted for source quality, intervention household drinking water showed reduced Escherichia coli counts (relative risk, 0.67; 95% CI, 0.50–0.89). Zero E. coli were obtained for drinking water in 56.9% of intervention households. The incidence rate ratio for bloody diarrhea was 0.20 (95% CI, 0.09–0.43; P < 0.001) and for non-bloody diarrhea was 0.17 (95% CI, 0.08–0.38; P < 0.001), indicating much lower diarrhea incidence among filter users. The results suggest that ceramic filters are effective in reducing diarrheal disease incidence.

Received September 1, 2007. Accepted for publication June 25, 2008.

Acknowledgments: The authors acknowledge the assistance of final year students at the University of Venda for Science and Technology, the Department of Health in the Limpopo Province, South. Africa, and the local authorities in Zaka District. We acknowledge the cooperation of the study participants and community leaders in both study sites, without whose assistance this work would not have been possible.

Financial support: This work was funded by the European Union under the INCO-DEV: International Co-operation with Developing Countries Programme (Contract ICA4-CT-2000-30039: Title: The Policy Implications of Contamination of Rural Water Between Source and Point-of-Use in Kenya, South Africa and Zimbabwe—AQUAPOL; www.bristol.ac.uk/aquapol/).

* Address correspondence to Martella du Preez, Natural Resources and the Environment, CSIR, PO Box 395, Pretoria 0001, South Africa. E-mail: mdupreez{at}csir.co.za

Authors’ addresses: Martella du Preez, Natural Resources and the Environment, CSIR, PO Box 395, Pretoria 0001, South Africa, Tel: 27-12-8413950, Fax: 27-12-8413954, E-mail: mdupreez{at}csir.co.za. Ronán M. Conroy, Department of Epidemiology and Preventive Medicine, Royal College of Surgeons in Ireland, Mercer Building, Dublin 2, Ireland, E-mail: rconroy{at}rcsi.ie. James A. Wright, Department of Geography, University of Southampton, Highfield, Southampton SO17 1BJ, UK, E-mail: J.A.Wright{at}soton.ac.uk. Sibonginkosi Moyo, Research and Technical Services, Institute of Water and Sanitation Development, PO Box MP 422 Mount Pleasant, Harare, Zimbabwe, E-mail: smoyo{at}iwsd.co.zw. Natasha Potgieter, Department of Microbiology, University of Venda for Science and Technology, Thohoyandou, Venda, South Africa, E-mail: Natasha.potgieter{at}univen.ac.za. Stephen W. Gundry, Water and Environmental Management Research Centre, University of Bristol, 83 Woodland Road, Bristol BS8 1US, UK, E-mail: stephen.gundry{at}bristol.ac.uk.






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Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.