ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2005. World Health Report 2005. Genev: World Health Organization.
-
2.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhea: systematic review and meta-analysis. BMJ 334: 782–791.
-
3.
Arnold BF, Colford JM, 2007. Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis. Am J Trop Med Hyg 76: 354–364.
-
4.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, 2005. Water, sanitation, and hygiene interventions to reduce diarrhea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42–52.
-
5.
Sobsey MD, 2002. Managing Water in the Home: Accelerated Health Gains from Improved Water Supply. Geneva: World Health Organization.
-
6.
Mintz ED, Reiff FM, Tauxe RVM, 1995. Safe water treatment and storage in the home: a practical new strategy to prevent waterborne disease. JAMA 273: 948–953.
-
7.
Quick R, Venczel L, Mintz ED, Soleto L, Aparicio J, Gironaz M, Hutwagner L, Greene K, Bopp C, Maloney K, Chavez D, Sobsey MD, Tauxe RV, 1999. Diarrhea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy. Epidemiol Infect 122: 83–90.
-
8.
Deb BC, Sircar BK, Sengupta PG, De SP, Mondal SK, Gupta DN, Saha NC, Ghosh S, Mitra U, Pal SC, 1986. Studies on interventions to prevent eltor cholera transmission in urban slums. Bull World Health Organ 64: 127–131.
-
9.
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.
-
10.
Macy JT, Quick RE, 1998. Evaluation of a novel drinking water treatment and storage intervention in Nicaragua: letter to the editor. Rev Panam Salud Publica/Pan. Am J Public Health 3: 135–136.
-
11.
Centers for Disease Control and Prevention, 2005. Safe Water System (SWS). Available at: http://www.cdc.gov/safewater/index.htm. Accessed July 1, 2006.
-
12.
Luby SP, Agboatwalla M, Painter J, Altaf A, Billhimer W, Keswick B, Hoekstra RM, 2006. Combining drinking water treatment and hand washing for diarrhea prevention, a cluster randomised controlled trial. Trop Med Int Health 11: 479–489.
-
13.
Crump JA, Otieno PO, Slutsker L, Keswick BH, Rosen DH, Hoekstra RM, Vulule JM, Luby SP, 2005. Household based treatment of drinking water with flocculant-disinfectant for preventing diarrhea in areas with turbid source water in rural western Kenya: cluster randomised controlled trial. BMJ 331: 478–483.
-
14.
Luby SP, Agboatwalla M, Hoekstra RM, Rahbar MH, Billhimer W, Keswick BH, 2004. Delayed effectiveness of home-based interventions in reducing childhood diarrhea, Karachi, Pakistan. Am J Trop Med Hyg 71: 420–427.
-
15.
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.
-
16.
Reller ME, Mendoza CE, Lopez MB, Alvarez M, Hoekstra 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.
-
17.
Population Services International, 2007. Water/Child Survival. Available at: http://www.psi.org/child-survival/safe-water.html. Accessed July 1, 2007.
-
18.
Clasen T, Edmondson P, 2006. Sodium dichloroisocyanurate (NaDCC) tablets as an alternative to sodium hypochlorite for the routine treatment of drinking water at the household level. Int J Hyg Environ Health 209: 173–181.
-
19.
United States Environmental Protection Agency, 2005. Product Label for Occidental Chemical Corporation Sodium Dichloroisocyanurate. Washington, DC: United States Environmental Protection Agency.
-
20.
World Health Organization, 2004. Evaluation of Certain Food Additives and Contaminants: Sixty-First Report of the Joint FAO/WHO Expert Committee on Food Additives: WHO Technical Report Series: 922. Geneva: World Health Organization.
-
21.
Solsona F, Méndez J, 2003. Water Disinfection. Lima, Peru: Pan American Center for Sanitary Engineering and Environmental Sciences (Pan American Health Organization).
-
22.
Clasen T, Saeed TF, Boisson S, Edmondson P, Shipin O, 2007. Household water treatment using sodium dichloroisocyanurate (NaDCC) tablets: a randomized, controlled trial to assess microbiological effectiveness in Bangladesh. Am J Trop Med Hyg 76: 187–192.
-
23.
deMagny GC, Cazelles B, Guégan JF, 2006. Cholera threat to humans in Ghana is influenced by both global and regional climatic variability. EcoHealth 3: 223–231.
-
24.
Idexx Co, 2007 Colilert®. Available at: http://www.idexx.com/water/colilert/. Accessed July 1, 2007.
-
25.
Ghana Statistical Service (GSS), Noguchi Memorial Institute for Medical Research (NMIMR), and ORC Macro, 2004. Ghana Demographic and Health Survey 2003. Calverton, MD: GSS, NMIMR, and ORC Macro:159–160.
-
26.
James KE, Block DA, Lee KK, Kraemer HC, Fuller RK, 1996. An index for assessing blindness in a multi-centre clinical trial: disulfiram for alcohol cessation—a VA cooperative study. Stat Med 15: 1421–1434.
-
27.
Colford JM, Rees JR, Wade TJ, Khalakdina A, Hilton JF, Ergas IJ, Burns S, Benker A, Ma C, Bowen C, Mills DC, Vugia DJ, Juranek DD, Levy DA, 2002. Participant blinding and gastrointestinal illness in a randomized, controlled trial of an in-home drinking water intervention. Emerg Infect Dis 8: 29–36.
-
28.
US Food and Drug Administration, 2006. Bacteriological Analytical Manual Appendix 2: Most Probable Number from Serial Dilutions. Available at: http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/BacteriologicalAnalyticalManualBAM/ucm109656.htm. Accessed March 11, 2007.
-
29.
Galal-Gorchev H, 1996. Chlorine in water disinfection. Pure Appl Chem 68: 1731–1735.
-
30.
Moe CL, Sobsey MD, Samsa GP, Mesolo V, 1991. Bacterial indicators of risk of diarrheal disease from drinking-water in the Philippines. Bull World Health Organ 69: 305–317.
-
31.
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.
-
32.
Pinfold JV, 1990. Faecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water supply and sanitation activities on faeco-oral disease transmission. II: a hygiene intervention study in north-east Thailand. Epidemiol Infect 105: 377–389.
-
33.
Kirchhoff LV, McClelland KE, Do Carmo Pinho M, Araujo JG, De Sousa MA, Guerrant RL, 1985. Feasibility and efficacy of in-home water chlorination in rural north-eastern Brazil. J Hyg (Lond) 94: 173–180.
-
34.
Wood L, Egger M, Gluud LL, Schulz KF, Jüni P, Altman DG, Gluud C, Martin RM, Wood AJ, Sterne JA, 2008. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ 336: 601–605.
-
35.
Colford JM, Wade TJ, Sandhu SK, Wright CC, Lee S, Shaw S, Fox K, Burns S, Benker A, Brookhart MA, van der Laan M, Levy DA, 2005. A randomized, controlled trial of in-home drinking water intervention to reduce gastrointestinal illness. Am J Epidemiol 161: 472–482.
-
36.
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: 697–700.
-
37.
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.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1183 | 651 | 52 |
| Full Text Views | 3232 | 9 | 0 |
| PDF Downloads | 276 | 11 | 0 |
Sodium Dichloroisocyanurate Tablets for Routine Treatment of Household Drinking Water in Periurban Ghana: A Randomized Controlled Trial
Seema Jain
Seema Jain
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Infectious Diseases (School of Medicine) and Center for Global Safe Water (Rollins School of Public Health), Emory University, Atlanta, Georgia; NewEnergy, Tamale, Ghana
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Osman K. Sahanoon
Osman K. Sahanoon
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Infectious Diseases (School of Medicine) and Center for Global Safe Water (Rollins School of Public Health), Emory University, Atlanta, Georgia; NewEnergy, Tamale, Ghana
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Elizabeth Blanton
Elizabeth Blanton
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Infectious Diseases (School of Medicine) and Center for Global Safe Water (Rollins School of Public Health), Emory University, Atlanta, Georgia; NewEnergy, Tamale, Ghana
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Ann Schmitz
Ann Schmitz
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Infectious Diseases (School of Medicine) and Center for Global Safe Water (Rollins School of Public Health), Emory University, Atlanta, Georgia; NewEnergy, Tamale, Ghana
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Kathleen A. Wannemuehler
Kathleen A. Wannemuehler
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Infectious Diseases (School of Medicine) and Center for Global Safe Water (Rollins School of Public Health), Emory University, Atlanta, Georgia; NewEnergy, Tamale, Ghana
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Robert M. Hoekstra
Robert M. Hoekstra
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Infectious Diseases (School of Medicine) and Center for Global Safe Water (Rollins School of Public Health), Emory University, Atlanta, Georgia; NewEnergy, Tamale, Ghana
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Robert E. Quick
Robert E. Quick
Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Infectious Diseases (School of Medicine) and Center for Global Safe Water (Rollins School of Public Health), Emory University, Atlanta, Georgia; NewEnergy, Tamale, Ghana
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We conducted a randomized, placebo-controlled, triple-blinded trial to determine the health impact of daily use of sodium dichloroisocyanurate (NaDCC) tablets for household drinking water treatment in periurban Ghana. We randomized 240 households (3,240 individuals) to receive either NaDCC or placebo tablets. All households received a 20-liter safe water storage vvessel. Over 12 weeks, 446 diarrhea episodes (2.2%) occurred in intervention and 404 (2.0%) in control households (P = 0.38). Residual free chlorine levels indicated appropriate tablet use. Escherichia coli was found in stored water at baseline in 96% of intervention and 88% of control households and at final evaluation in 8% of intervention and 54% of control households (P = 0.002). NaDCC use did not prevent diarrhea but improved water quality. Diarrhea rates were low and water quality improved in both groups. Safe water storage vessels may have been protective. A follow-up health impact study of NaDCC tablets is warranted.
Author Notes
Financial support: The United States Agency for International Development, the Bureau of Oceans and Environmental Science of the United States Department of State, Medentech Ltd, and the Chlorine Chemistry Council funded the study. Medentech, Ltd provided NaDCC and placebo tablets.
Authors' addresses: Seema Jain, Elizabeth Blanton, Ann Schmitz, Kathleen A. Wannemuehler, Robert M. Hoekstra, and Robert E. Quick, Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: bwc8@cdc.gov. Osman K. Sahanoon, NewEnergy, Tamale, Ghana.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2005. World Health Report 2005. Genev: World Health Organization.
-
2.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhea: systematic review and meta-analysis. BMJ 334: 782–791.
-
3.
Arnold BF, Colford JM, 2007. Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis. Am J Trop Med Hyg 76: 354–364.
-
4.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, 2005. Water, sanitation, and hygiene interventions to reduce diarrhea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42–52.
-
5.
Sobsey MD, 2002. Managing Water in the Home: Accelerated Health Gains from Improved Water Supply. Geneva: World Health Organization.
-
6.
Mintz ED, Reiff FM, Tauxe RVM, 1995. Safe water treatment and storage in the home: a practical new strategy to prevent waterborne disease. JAMA 273: 948–953.
-
7.
Quick R, Venczel L, Mintz ED, Soleto L, Aparicio J, Gironaz M, Hutwagner L, Greene K, Bopp C, Maloney K, Chavez D, Sobsey MD, Tauxe RV, 1999. Diarrhea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy. Epidemiol Infect 122: 83–90.
-
8.
Deb BC, Sircar BK, Sengupta PG, De SP, Mondal SK, Gupta DN, Saha NC, Ghosh S, Mitra U, Pal SC, 1986. Studies on interventions to prevent eltor cholera transmission in urban slums. Bull World Health Organ 64: 127–131.
-
9.
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.
-
10.
Macy JT, Quick RE, 1998. Evaluation of a novel drinking water treatment and storage intervention in Nicaragua: letter to the editor. Rev Panam Salud Publica/Pan. Am J Public Health 3: 135–136.
-
11.
Centers for Disease Control and Prevention, 2005. Safe Water System (SWS). Available at: http://www.cdc.gov/safewater/index.htm. Accessed July 1, 2006.
-
12.
Luby SP, Agboatwalla M, Painter J, Altaf A, Billhimer W, Keswick B, Hoekstra RM, 2006. Combining drinking water treatment and hand washing for diarrhea prevention, a cluster randomised controlled trial. Trop Med Int Health 11: 479–489.
-
13.
Crump JA, Otieno PO, Slutsker L, Keswick BH, Rosen DH, Hoekstra RM, Vulule JM, Luby SP, 2005. Household based treatment of drinking water with flocculant-disinfectant for preventing diarrhea in areas with turbid source water in rural western Kenya: cluster randomised controlled trial. BMJ 331: 478–483.
-
14.
Luby SP, Agboatwalla M, Hoekstra RM, Rahbar MH, Billhimer W, Keswick BH, 2004. Delayed effectiveness of home-based interventions in reducing childhood diarrhea, Karachi, Pakistan. Am J Trop Med Hyg 71: 420–427.
-
15.
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.
-
16.
Reller ME, Mendoza CE, Lopez MB, Alvarez M, Hoekstra 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.
-
17.
Population Services International, 2007. Water/Child Survival. Available at: http://www.psi.org/child-survival/safe-water.html. Accessed July 1, 2007.
-
18.
Clasen T, Edmondson P, 2006. Sodium dichloroisocyanurate (NaDCC) tablets as an alternative to sodium hypochlorite for the routine treatment of drinking water at the household level. Int J Hyg Environ Health 209: 173–181.
-
19.
United States Environmental Protection Agency, 2005. Product Label for Occidental Chemical Corporation Sodium Dichloroisocyanurate. Washington, DC: United States Environmental Protection Agency.
-
20.
World Health Organization, 2004. Evaluation of Certain Food Additives and Contaminants: Sixty-First Report of the Joint FAO/WHO Expert Committee on Food Additives: WHO Technical Report Series: 922. Geneva: World Health Organization.
-
21.
Solsona F, Méndez J, 2003. Water Disinfection. Lima, Peru: Pan American Center for Sanitary Engineering and Environmental Sciences (Pan American Health Organization).
-
22.
Clasen T, Saeed TF, Boisson S, Edmondson P, Shipin O, 2007. Household water treatment using sodium dichloroisocyanurate (NaDCC) tablets: a randomized, controlled trial to assess microbiological effectiveness in Bangladesh. Am J Trop Med Hyg 76: 187–192.
-
23.
deMagny GC, Cazelles B, Guégan JF, 2006. Cholera threat to humans in Ghana is influenced by both global and regional climatic variability. EcoHealth 3: 223–231.
-
24.
Idexx Co, 2007 Colilert®. Available at: http://www.idexx.com/water/colilert/. Accessed July 1, 2007.
-
25.
Ghana Statistical Service (GSS), Noguchi Memorial Institute for Medical Research (NMIMR), and ORC Macro, 2004. Ghana Demographic and Health Survey 2003. Calverton, MD: GSS, NMIMR, and ORC Macro:159–160.
-
26.
James KE, Block DA, Lee KK, Kraemer HC, Fuller RK, 1996. An index for assessing blindness in a multi-centre clinical trial: disulfiram for alcohol cessation—a VA cooperative study. Stat Med 15: 1421–1434.
-
27.
Colford JM, Rees JR, Wade TJ, Khalakdina A, Hilton JF, Ergas IJ, Burns S, Benker A, Ma C, Bowen C, Mills DC, Vugia DJ, Juranek DD, Levy DA, 2002. Participant blinding and gastrointestinal illness in a randomized, controlled trial of an in-home drinking water intervention. Emerg Infect Dis 8: 29–36.
-
28.
US Food and Drug Administration, 2006. Bacteriological Analytical Manual Appendix 2: Most Probable Number from Serial Dilutions. Available at: http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/BacteriologicalAnalyticalManualBAM/ucm109656.htm. Accessed March 11, 2007.
-
29.
Galal-Gorchev H, 1996. Chlorine in water disinfection. Pure Appl Chem 68: 1731–1735.
-
30.
Moe CL, Sobsey MD, Samsa GP, Mesolo V, 1991. Bacterial indicators of risk of diarrheal disease from drinking-water in the Philippines. Bull World Health Organ 69: 305–317.
-
31.
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.
-
32.
Pinfold JV, 1990. Faecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water supply and sanitation activities on faeco-oral disease transmission. II: a hygiene intervention study in north-east Thailand. Epidemiol Infect 105: 377–389.
-
33.
Kirchhoff LV, McClelland KE, Do Carmo Pinho M, Araujo JG, De Sousa MA, Guerrant RL, 1985. Feasibility and efficacy of in-home water chlorination in rural north-eastern Brazil. J Hyg (Lond) 94: 173–180.
-
34.
Wood L, Egger M, Gluud LL, Schulz KF, Jüni P, Altman DG, Gluud C, Martin RM, Wood AJ, Sterne JA, 2008. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ 336: 601–605.
-
35.
Colford JM, Wade TJ, Sandhu SK, Wright CC, Lee S, Shaw S, Fox K, Burns S, Benker A, Brookhart MA, van der Laan M, Levy DA, 2005. A randomized, controlled trial of in-home drinking water intervention to reduce gastrointestinal illness. Am J Epidemiol 161: 472–482.
-
36.
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: 697–700.
-
37.
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.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1183 | 651 | 52 |
| Full Text Views | 3232 | 9 | 0 |
| PDF Downloads | 276 | 11 | 0 |