REDUCING DIARRHEA THROUGH THE USE OF HOUSEHOLD-BASED CERAMIC WATER FILTERS: A RANDOMIZED, CONTROLLED TRIAL IN RURAL BOLIVIA

THOMAS F. CLASEN Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina; First Water, Ltd., Bristol, United Kingdom; Fundación Sumaj Huasi, La Paz, Bolivia

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JOSEPH BROWN Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina; First Water, Ltd., Bristol, United Kingdom; Fundación Sumaj Huasi, La Paz, Bolivia

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SIMON COLLIN Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina; First Water, Ltd., Bristol, United Kingdom; Fundación Sumaj Huasi, La Paz, Bolivia

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OSCAR SUNTURA Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina; First Water, Ltd., Bristol, United Kingdom; Fundación Sumaj Huasi, La Paz, Bolivia

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SANDY CAIRNCROSS Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina; First Water, Ltd., Bristol, United Kingdom; Fundación Sumaj Huasi, La Paz, Bolivia

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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%; P < 0.001). For children less than five years old, the reduction in risk was 83% (95% CI = 51–94%; P < 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.

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