1921
Volume 91, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Safe domestic potable water supplies are urgently needed to reduce childhood diarrheal disease. In periurban neighborhoods in Cochabamba, Bolivia, we conducted a cluster randomized controlled trial to evaluate the efficacy of a household-level hollow fiber filter and/or behavior change communication (BCC) on water, sanitation, and hygiene (WASH) to reduce the diarrheal disease in children less than 5 years of age. In total, 952 households were followed for a period of 12 weeks post-distribution of the study interventions. Households using Sawyer PointONE filters had significantly less diarrheal disease compared with the control arm during the intervention period, which was shown by diarrheal prevalence ratios of 0.21 (95% confidence interval [95% CI] = 0.15–0.30) for the filter arm and 0.27 (95% CI = 0.22–0.34) for the filter and WASH BCC arm. A non-significant reduction in diarrhea prevalence was reported in the WASH BCC study arm households (0.71, 95% CI = 0.59–0.86).

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.13-0568
2014-07-02
2018-12-13
Loading full text...

Full text loading...

/deliver/fulltext/14761645/91/1/190.html?itemId=/content/journals/10.4269/ajtmh.13-0568&mimeType=html&fmt=ahah

References

  1. Bartram J, Cairncross S, , 2010. Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med 7: 19.[Crossref] [Google Scholar]
  2. United Nations Children's Fund and World Health Organization, 2012. Progress on Drinking Water and Sanitation: 2012 Update. New York, NY: United Nations Children's Fund. [Google Scholar]
  3. United Nations, 2012. The Millennium Development Goals Report 2012. Available at: http://www.un.org/millenniumgoals/pdf/MDG%20Report%202012.pdf. Accessed September 28, 2013. [Google Scholar]
  4. Institute for Health Metrics and Evaluation (IHME), 2012. Global Burden of Disease Study 2010. Global Burden of Disease Study 2010 (GBD 2010) Results by Risk Factor 1990–2010. Seattle, WA: Institute for Health Metrics and Evaluation (IHME). [Google Scholar]
  5. World Health Organization, 2010. GLAAS 2010: UN-Water Global Annual Assessment of Sanitation and Drinking-Water: Targeting Resources for Better Results. Geneva: World Health Organization. [Google Scholar]
  6. Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R, Eisele T, Liu L, Mathers C, , 2010. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375: 19691987.[Crossref] [Google Scholar]
  7. Centro de Documentación e Información Bolivia, 2007. Datos del Distrito 8. Cochabamba, Bolivia: Centro de Documentación e Información Bolivia. [Google Scholar]
  8. Centro de Documentación e Información Bolivia, 2007. Datos del Distrito 14. Cochabamba, Bolivia: Centro de Documentación e Información Bolivia. [Google Scholar]
  9. Coa R, Ochoa LH, , 2009. Encuesta Nacional de Demografía y Salud: ENDSA 2008. La Paz, Bolivia: Ministerio de Salud y Deportes. [Google Scholar]
  10. United Nations Children's Fund and World Health Organization, 2009. Diarrhoea: Why Children Are Still Dying and What Can Be Done. New York, NY: United Nations Children's Fund, 68. [Google Scholar]
  11. World Health Organization, 2011. Evaluating Household Water Treatment Options: Health-Based Targets and Microbiological Performance Specifications. Geneva: World Health Organization. [Google Scholar]
  12. Stauber CE, Elliott MA, Koksal F, Ortiz GM, DiGiano FA, Sobsey MD, , 2006. Characterisation of the biosand filter for E. coli reductions from household drinking water under controlled laboratory and field use conditions. Water Sci Technol 54: 17.[Crossref] [Google Scholar]
  13. Stauber CE, Ortiz GM, Loomis DP, Sobsey MD, , 2009. A randomized controlled trial of the concrete biosand filter and its impact on diarrheal disease in Bonao, Dominican Republic. Am J Trop Med Hyg 80: 286293. [Google Scholar]
  14. Clasen TF, Suntura O, Cairncross S, , 2004. Reducing diarrhea through the use of household-based ceramic water filters: a randomized, controlled trial in rural Bolivia. Am J Trop Med Hyg 70: 651657. [Google Scholar]
  15. Clasen TF, Brown J, Collin SM, , 2006. Preventing diarrhoea with household ceramic water filters: assessment of a pilot project in Bolivia. Int J Environ Health Res 16: 231239.[Crossref] [Google Scholar]
  16. Duke WF, Nordin RN, Baker D, Mazumder A, , 2006. The use and performance of BioSand filters in the Artibonite Valley of Haiti: a field study of 107 households. Rural Remote Health 6: 570. [Google Scholar]
  17. Hydreion LLC (Missoula, MT), 2005. Microbiological Testing of the Sawyer 7/6B Filter. Report No. S05-03. Available at: http://sawyer.com/wp-content/uploads/2013/12/field-micro.pdf. Accessed January 29, 2013. [Google Scholar]
  18. Sawyer Corporation, 2013. What Can I Expect as a Flow Rate from My PointONE Filter. Available at: http://sawyer.com/wp-content/uploads/2013/12/flow-full1.pdf. Accessed January 29, 2013. [Google Scholar]
  19. Faul F, Erdfelder E, Lang AG, Buchner A, , 2007. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39: 175191.[Crossref] [Google Scholar]
  20. Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, , 2007. Interventions to improve water quality for preventing diarrhoea: systematic review and meta-analysis. BMJ 334: 782.[Crossref] [Google Scholar]
  21. Christakis NA, Fowler JH, , 2007. The spread of obesity in a large social network over 32 years. N Engl J Med 357: 370379.[Crossref] [Google Scholar]
  22. Christakis NA, Fowler JH, , 2008. The collective dynamics of smoking in a large social network. N Engl J Med 358: 22492258.[Crossref] [Google Scholar]
  23. Fowler JH, Christakis NA, , 2008. Estimating peer effects on health in social networks: a response to Cohen-Cole and Fletcher; Trogdon, Nonnemaker, Pais. J Health Econ 27: 14001405.[Crossref] [Google Scholar]
  24. Fowler JH, Christakis NA, , 2008. Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study. BMJ 337: a2338.[Crossref] [Google Scholar]
  25. Davis TP, , 2004. Barrier Analysis Facilitator's Guide: A Tool for Improving Behavior Change Communication in Child Survival and Community Development Programs. Washington, DC: Food for the Hungry. [Google Scholar]
  26. Laughlin M, , 2004. The Care Group Difference: A Guide to Mobilizing Community Based Volunteer Health Educators. Baltimore, MD: World Relief. [Google Scholar]
  27. Liang KY, Zeger SL, , 1986. Longitudinal data analysis using generalized linear models. Biometrika 73: 1322.[Crossref] [Google Scholar]
  28. Emrich LJ, Piedmonte MR, , 1992. On some small sample properties of generalized estimating equation estimates for multivariate dichotomous outcomes. J Stat Comput Simul 41: 1929.[Crossref] [Google Scholar]
  29. Dinerstein E, Olson DM, Graham DJ, , 1995. A Conservation Assessment of the Terrestrial Ecoregions of Latin America and the Caribbean. Washington, DC: The World Bank.[Crossref] [Google Scholar]
  30. Brown J, Sobsey MD, Loomis D, , 2008. Local drinking water filters reduce diarrheal disease in Cambodia: a randomized, controlled trial of the ceramic water purifier. Am J Trop Med Hyg 79: 394400. [Google Scholar]
  31. Stauber C, Printy E, McCarty F, Liang K, Sobsey M, , 2011. Cluster randomized controlled trial of the plastic biosand water filter in Cambodia. Environ Sci Technol 46: 722728.[Crossref] [Google Scholar]
  32. Hunter PR, , 2009. Household water treatment in developing countries: comparing different intervention types using meta-regression. Environ Sci Technol 43: 89918997.[Crossref] [Google Scholar]
  33. Alam N, Henry FJ, Rahaman MM, , 1989. Reporting errors in one-week diarrhoea recall surveys: experience from a prospective study in rural Bangladesh. Int J Epidemiol 18: 697700.[Crossref] [Google Scholar]
  34. Boerma JT, Black RE, Sommerfelt AE, Rutstein SO, Bicego GT, , 1991. Accuracy and completeness of mothers' recall of diarrhoea occurrence in pre-school children in demographic and health surveys. Int J Epidemiol 20: 10731080.[Crossref] [Google Scholar]
  35. Schmidt WP, Luby SP, Genser B, Barreto ML, Clasen T, , 2007. Estimating the longitudinal prevalence of diarrhea and other episodic diseases: continuous versus intermittent surveillance. Epidemiology 18: 537543.[Crossref] [Google Scholar]
  36. Melo MC, Taddei JA, Diniz-Santos DR, May DS, Carneiro NB, Silva LR, , 2007. Incidence of diarrhea: poor parental recall ability. Braz J Infect Dis 11: 571579.[Crossref] [Google Scholar]
  37. Emanuel EJ, Wendler D, Killen J, Grady C, , 2004. What makes clinical research in developing countries ethical? The benchmarks of ethical research. J Infect Dis 189: 930937.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.13-0568
Loading
/content/journals/10.4269/ajtmh.13-0568
Loading

Data & Media loading...

  • Received : 30 Sep 2013
  • Accepted : 07 Mar 2014

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error