A RANDOMIZED CONTROLLED TRIAL OF HOUSEHOLD-BASED FLOCCULANT-DISINFECTANT DRINKING WATER TREATMENT FOR DIARRHEA PREVENTION IN RURAL GUATEMALA

MEGAN E. RELLER Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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CARLOS E. MENDOZA Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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M. BEATRIZ LOPEZ Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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MARICRUZ ALVAREZ Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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ROBERT M. HOEKSTRA Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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CHRISTY A. OLSON Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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KATHLEEN G. BAIER Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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BRUCE H. KESWICK Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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STEPHEN P. LUBY Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Universidad del Valle de Guatemala, Medical Entomology Research and Training Unit, Guatemala City, Guatemala; Procter & Gamble Company, Cincinnati, Ohio

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We conducted a study to determine if use of a new flocculant-disinfectant home water treatment reduced diarrhea. We randomly assigned 492 rural Guatemalan households to five different water treatment groups: flocculant-disinfectant, flocculant-disinfectant plus a customized vessel, bleach, bleach plus a vessel, and control. During one year of observation, residents of control households had 4.31 episodes of diarrhea per 100 person-weeks, whereas the incidence of diarrhea was 24% lower among residents of households receiving flocculant-disinfectant, 29% lower among those receiving flocculant-disinfectant plus vessel, 25% lower among those receiving bleach, and 12% lower among households receiving bleach plus vessel. In unannounced evaluations of home drinking water, free chlorine was detected in samples from 27% of flocculant-disinfectant households, 35% of flocculant-disinfectant plus vessel households, 35% of bleach households, and 43% of bleach plus vessel households. In a setting where diarrhea was a leading cause of death, intermittent use of home water treatment with flocculant-disinfectant decreased the incidence of diarrhea.

Author Notes

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