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A Randomized Controlled Trial of the Concrete Biosand Filter and Its Impact on Diarrheal Disease in Bonao, Dominican Republic

A number of household water treatment and safe storage technologies, such as chlorine disinfection, solar disinfection, and ceramic filtration, have been documented for their ability to reduce diarrheal disease and improve microbial water quality. The biosand filter (BSF) is a promising household water treatment technology in use by > 500,000 people globally. The purpose of this research was to document the ability of BSFs to improve water quality and to reduce diarrheal disease in user compared with non-user households in a randomized controlled trial in Bonao, Dominican Republic, during 2005–2006. During the 6-month intervention period, 75 BSF households had significantly improved drinking water quality on average compared with 79 control households (P < 0.001). Based on random intercepts logistic regression, BSF households had 0.53 times the odds of diarrheal disease as control households, indicating a significant protective effect of the BSF against waterborne diarrheal disease.

Received March 11, 2008. Accepted for publication October 23, 2008.

Acknowledgments: The authors thank all of the study participants from the communities of Jayaco and Brisas del Yuna, Bonao, Dominican Republic. Without their time and patience, this study would not have been possible. We also thank the interviewers from the community of Jayaco, Bonao, DR, and the staff of Dr. Mirna Peña de Guerra’s laboratory for all of their technical assistance. Thanks also to Douglas Wait and the UNC Environmental Microbiology and Health group.

Financial support: Laboratory supplies for water quality testing were graciously donated by IDEXX Laboratories and Hach Company. We are grateful to the many Rotary Districts and Clubs of Michigan and Colorado, the Canadian Embassy of The Dominican Republic, the W. K. Kellogg Foundation, and the Fulbright Award for generous financial support of this study.

^* Address correspondence to Christine E. Stauber, Georgia State University, Institute of Public Health, P.O. Box 3995, Atlanta, GA 30302-3995. E-mail: cstauber{at}gsu.edu

Authors’ addresses: Christine E. Stauber, Georgia State University, Institute of Public Health, PO Box 3995, Atlanta, GA 30302-3995, Tel: 404-413-1128, Fax: 404-413-1140. Gloria M. Ortiz, University of North Carolina—Chapel Hill, School of Public Health, Department of Environmental Sciences and Engineering, CB 7431 Rosenau Hall 148, Chapel Hill, NC 27599-7431, Tel: 919-966-7316, Fax: 919-966-7911. Dana Loomis, School of Public Health/271, University of Nevada, Reno, Reno, NV 89557-0036, Tel: 775-682-7103, Fax: 775-784-1340. Mark D. Sobsey, University of North Carolina—Chapel Hill, School of Public Health, Department of Environmental Sciences and Engineering, CB 7431 Rosenau Hall, Chapel Hill, NC 27599-7431, Tel: 919-966-7303, Fax: 919-966-7911.

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