1921
Volume 71, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

We introduced home drinking water disinfection and handwashing with soap in Karachi squatter settlements to evaluate their effect on diarrhea. In April 2000, 150 households received soap, 76 received dilute bleach and a water storage vessel, and 76 were enrolled as controls. In 2000, among households wealthy enough to own a refrigerator, children in households that received bleach and a vessel had a 73% lower incidence of diarrhea than controls; those that received soap had a 56% lower incidence. There was no reduction in diarrhea in intervention households without a refrigerator. In 2001, households that received bleach and a vessel had a 71% lower incidence of diarrhea and children in households that received soap had a 35% lower incidence than controls. In 2001, the interventions were equally effective in households that had a refrigerator and those that did not. Both of these home-based interventions were ultimately effective in preventing diarrhea, but only households of slightly higher socioeconomic status changed their behavior quickly enough to benefit during the first summer.

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2004-10-01
2017-11-22
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References

  1. WHO, 2002. The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization.
  2. Black RE, Morris SS, Bryce J, 2003. Where and why are 10 million children dying every year? Lancet 361 : 2226–2234.
  3. 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.
  4. 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.
  5. 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.
  6. Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis. 3 : 275–281.
  7. Planning and Development Corporation and Pakistan Environmental Planning and Architecture Consultant, 1990. Karachi Development Plan 2000. United Nation Centre for Human Settlements. United Natons Development Program Project Pak/80/019, Karachi Master Plan 1986–2000.
  8. Marsh D, Husein K, Lobo M, Ali Shah M, Luby S, 1995. Verbal autopsy in Karachi slums: comparing single and multiple cause of child deaths. Health Policy Plann 10 : 395–403.
  9. Luby S, Agboatwalla M, Raza A, Sobel J, Mintz E, Baier K, Rahbar M, Qureshi S, Hassan R, Ghouri F, Hoekstra R, Gangarosa E, 2001. A low-cost intervention for cleaner drinking water in Karachi, Pakistan. Int J Infect Dis 5 : 144–150.
  10. Luby S, Agboatwalla M, Raza A, Sobel J, Mintz ED, Baier K, Hoekstra RM, Rahbar MH, Hassan R, Qureshi SM, Gangarosa EJ, 2001. Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan. Epidemiol Infect 127 : 237–244.
  11. Luby S, Agboatwalla M, Schnell BM, Hoekstra RM, Rahbar MH, Keswick BH, 2002. The effect of antibacterial soap on impetigo incidence, Karachi, Pakistan. Am J Trop Med Hyg 67 : 430–435.
  12. Heinze JE, Yackovich F, 1988. Washing with contaminated bar soap is unlikely to transfer bacteria. Epidemiol Infect 101 : 135–142.
  13. Walsh SE, Maillard JY, Russell AD, Catrenich CE, Charbonneau DL, Bartolo RG, 2003. Activity and mechanisms of action of selected biocidal agents on Gram-positive and -negative bacteria. J Appl Microbiol 94 : 240–247.
  14. Zeger SL, Liang K-Y, 1986. Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42 : 121–130.
  15. Rogers EM, 1995. Diffusion of Innovations. Fourth Edition. New York: The Free Press.
  16. Reller ME, Mendoza CE, Lopez MB, Alvarez M, Hoeskstra RM, Olson CA, Baier KG, Keswick BH, Luby SP, 2003. A randomized controlled trial of household based flocculant-disinfectant drinking water treatment for diarrhea prevention in rural Guatemala. Am J Trop Med Hyg 69 : 411–419.
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  • Received : 06 Oct 2003
  • Accepted : 20 Apr 2004

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