Volume 70, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Ceramic water filters have been identified as one of the most promising and accessible technologies for treating water at the household level. In a six-month trial, water filters were distributed randomly to half of the 50 participating households in a rural community in Bolivia; the remaining households continued to use customary water handling practices and served as controls. In four rounds of sampling following distribution of the filters, 100% of the 96 water samples from the filter households were free of thermotolerant coliforms compared with 15.5% of the control household samples. Diarrheal disease risk for individuals in intervention households was 70% lower than for controls (95% confidence interval [CI] = 53–80%; < 0.001). For children less than five years old, the reduction in risk was 83% (95% CI = 51–94%; < 0.001). These results show that affordable ceramic water filters enable low-income households to treat and maintain the microbiologic quality of their drinking water.


Article metrics loading...

Loading full text...

Full text loading...



  1. Kosek M, Bern C, Guerrant RL, 2003. The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000. Bull World Health Organ 81 : 197–204.
  2. Parashar UD, Bresee JS, Glass RI, 2003. The global burden of diarrhoeal disease in children (editorial). Bull World Health Organ 81 : 236.
  3. Ministry of Health, Bolivia, 2003. Salud del Niño. Available at www.sns.gov.bo/salnin.html.
  4. Guerrant DI, Moore SR, Lima AA, Patrick P, Schorling JB, Guerrant RL, 1999. Association of early childhood diarrhoea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil. Am J Trop Med Hyg 61 : 707–713.
  5. Baqui AH, Black RE, Sack RB, Chowdhury HR, Yunus M, Sid-dique AK, 1993. Malnutrition, cell-mediated immune deficiency and diarrhea: a community-based longitudinal study in rural Bangladeshi children. Am J Epidemiol 137 : 355–365.
  6. Schneider RE, Shiffman M, Faigenblum J, 1978. The potential effect of water on gastrointestinal infections prevalent in developing countries. Am J Clin Nutr 31 : 2089–2099.
  7. WHO/UNICEF, 2000. Global Water Supply and Sanitation Assessment. Geneva: World Health Organization. Available at http://www.wssinfo.org/en/pdf.
  8. Sobsey MD, 2002. Managing Water in the Home: Accelerated Health Gains from Improved Water Supply. Geneva: World Health Organization (WHO/SDE/WSH/02.07). Available at http://www.who.int/water_sanitation_health/dwq/wsh0207/en/.
  9. Clasen T, Bastable A, 2003. Faecal contamination of drinking water during collection and household storage: the need to extend protection to the point of use. J Water Health 1 : 109–115.
  10. Ciesceri LS, Greenberg AE, Eaton AD, eds, 1998. Standard Methods for Examination of Water and Wastewater. 20th edition. Washington, DC: American Public Health Association.
  11. Morris SS, Cousens SN, Kirkwood BR, Arthur P, Ross DA, 1996. Is prevalence of diarrhea a better predictor of subsequent mortality and weight gain than diarrhea incidence? Am J Epidemiol 144 : 582–588.
  12. Thevos A, Olsen S, Rangel J, Kaona F, Tembo M, Quick R, 2003. Social mrketing and motivational interviewing as community interventions for safe water behaviors: follow-up surveys in Zambia. Int Q Community Health Education 21 : 51–65.
  13. 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 : 1073–1080.
  14. Hörman A, 2003. Evaluation of the purification capacity of nine portable, small scale water purification devices. Proceedings of the International Water Association/WHO International Symposium on Health-Related Water Microbiology. Cape Town, South Africa, September 14–19, 2003.
  15. Ongerth JE, Johnson RL, Macdonals SC, Frost F, Stibbs HH, 1989. Backcountry water treatment to prevent giardiasis. Am J Public Health 79 : 1633–1637.
  16. Quick R, Venczel L, Gonzalez O, Mintz E, Highsmith A, Espada A, Damiani E, Bean N, de Hannover R, Tauxe R, 1996. Narrow-mouthed water storage vessels and in situ chlorination in a Bolivian community: a simple method to improve drinking water quality. Am J Trop Med Hyg. 54 : 511–516.
  17. Luby S, Agboatwalla M, Raza A, Sobel J, 2001. A low-cost intervention for cleaner drinking water in Karachi, Pakistan. Int J Infect Dis 5 : 144–150.
  18. McGuigan KG, Joyce TM, Conroy RM, Gillespie JB, Elmore-Meegan M, 1998. Solar disinfection of drinking water contained in transparent plastic bottles: characterizing the bacterial inactivation process. J Appl Microbiol 84 : 1138–1148.
  19. Rangel J, Lopez B, Alvarez MM, Mendoza C, Luby S, 2003. A novel techonolgy to improve drinking water quality: a micro-biological evaluation of in-home flocculation and chlorination in rural Guatemala. J Water Health 1 : 15–22.
  20. Wright J, Gundry S, Conroy R, 2003. Household drinking water in developing countries: a systematic review of microbiological contamination between source and point-of-use. Trop Med Int Health 9 : 106–117.
  21. Roberts L, Chartier Y, Chartier O, Malenga G, Toole M, Rodka H, 2001. Keeping clean water clean in a Malawi refugee camp: a randomized intervention trial. Bull World Health Organ 79 : 280–287.
  22. Esrey SA, Feachem RG, Hughes JM, 1985. Interventions for the control of diarrhoeal diseases among young children: improving water supplies and excreta disposal facilities. Bull World Health Organ 64 : 776–782.
  23. Esrey SA, Potash JB, Roberts L, Shiff C, 1991. Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and tracoma. Bull World Health Organ 69 : 609–621.
  24. Esrey SA, Habicht J-P, 1986. Epidemiologic evidence for health benefits from improved water and sanitation in developing countries. Epidemiol Rev 8 : 117–128.
  25. Sobsey MD, Handzel T, Venczel L, 2003. Chlorination and safe storage of household drinking water in developing countries to reduce waterborne disease. Water Sci Technol 47 : 221–228.
  26. Reller ME, Mendoza CE, Lopez MB, Alvarez M, Hoekstra RM, Olson CA, Baier KG, Keswick BH, Luby SP, 2002. A randomized controlled trial of household-based flocculant-disinfectant drinking water treatment for diarrhea prevention in rural Guatemala. Am J Trop Med Hyg 64 : 411–419.
  27. Quick RE, Kimura A, Thevos A, Tembo M, Shamputa I, Hutwagner L, Mintz E, 2002. Diarrhea prevention through household-level water disinfection and safe storage in Zambia. Am J Trop Med Hyg 66 : 584–589.
  28. Conroy RM, Meegan ME, Joyce T, McGuigan K, Barnes J, 1999. Solar disinfection of water reduces diarrhoeal disease: an update. Arch Dis Child 81 : 337–338.
  29. Iijima Y, Karama M, Oundo JO, Honda T, 2001. Prevention of bacterial diarrhea by pasteurization of drinking water in Kenya. Microbiol. Immunol. 45 : 413–416.
  30. Quick RE, Venczel LV, Mintz ED, Soleto L, Aparicio J, Gironaz M, Hutwagner L, Greene K, Bopp C, Maloney K, Chavez D, Sobsey M, Tauxe RV, 1999. Diarrhoea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy. Epidemiol Infect 122 : 83–90.
  31. Semenza JC, Roberts L, Henderson A, Bogan J, Rubin CH, 1998. Water distribution system and diarrheal disease transmission: a case study in Uzbekistan. Am J Trop Med Hyg 59 : 941–946.
  32. Mahfouz A, Abdel-Moneim M, Al-Erian R, Al-Mari O, 1995. Impact of chlorination of water in domestic storage tanks on childhood diarrhoea: a community trial in the rural areas of Saudi Arabia. J Trop Med Hyg 98 : 126–130.
  33. Deb BC, Sircar BK, Sengupta PG, De SP, Mondal SK, Gupta DN, Daha NC, Ghosh S, Mitra U, Pal SC, 1986. Studies on interventions to prevent El Tor cholera transmission in uran slums. Bull World Health Organ 64 : 127–131.
  34. Clasen T, 2003. Disease reduction through household water treatment. Proceedings of the International Water Association/ WHO International Symposium on Health-Related Water Microbiology. Cape Town, South Africa, September 14–19, 2003.
  35. Clasen T, Roberts I, Rabie T, Cairncross S, 2004. Interventions to improve water quality for preventing infectious diarrhoea (Protocol for a Cochrane Review). The Cochrane Library, Issue 2, 2004.
  36. Clasen T, Cairncross S, 2004. Household water treatment: refining the dominant paradigm. Trop Med Intl Health 9 : 187–191.
  37. Melnick JL, Gerba CP, Wallis C, 1978. Viruses in water. Bull World Health Organ 56 : 499–508.
  38. Almeida LM, Werneck GL, Cairncross S, Coeli CM, Costa MC, Coletty PE, 2001. The epidemiology of hepatitis A in Rio de Janeiro: environmental and domestic risk factors. Epidemiol Infect 127 : 327–333.
  39. Scott TM, Sabo RC, Lukasik J, Boice C, Shaw K, Arroso-Giachetti L, El-Shall H, Farrah SR, Park C, Moudgil B, Koopman B, 2002. Performance and cost-effectiveness of ferric and aluminium hydrous metal oxide coating on filter media to enhance virus removal. KONA 20 : 159–167.

Data & Media loading...

  • Received : 08 Dec 2003
  • Accepted : 23 Feb 2004

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