World Health Organization and United Nations Children's Fund, 2010. Progress on Sanitation and Drinking Water 2010 Update. Available at: http://www.who.int/water_sanitation_health/publications/9789241563956/en/index.html. Accessed June 25, 2010.
World Health Organization, 2008. Household Water Treatment and Safe Storage. Available at: http://www.who.int/household_water/en/index.html. Accessed June 9, 2008.
Sobsey MD, 2002. Managing Water in the Home: Accelerated Health Gains from Improved Water Supply. Geneva, Switzerland: World Health Organization.
Schmidt WP, Cairncross S, 2009. Household water treatment in poor populations: is there enough evidence for scaling up now. Environ Sci Technol 43: 986–992.
Rose A, Roy S, Abraham V, Holmgren G, George K, Balraj V, Abraham S, Muliyil J, Joseph A, Kang G, 2006. Solar disinfection of water for diarrhoeal prevention in southern India. Arch Dis Child 91: 139–141.
Rainey RC, Harding AK, 2005. Acceptability of solar disinfection of drinking water treatment in Kathmandu Valley, Nepal. Int J Environ Res Public Health 15: 361–372.
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.
Brown J, Sobsey M, Proum S, 2007. Use of Ceramic Water Filters in Cambodia. Available at: http://www.wsp.org/UserFiles/file/926200724252_eap_cambodia_filter.pdf. Accessed February 23, 2009.
Hunter PR, 2009. Household water treatment in developing countries: comparing different intervention types using meta-regression. Environ Sci Technol 43: 8991–8997.
Sobsey MD, Stauber CE, Casanova LM, Brown JM, Elliot MA, 2008. Point of use household drinking water filtration: a practical, effective solution for providing sustained access to safe drinking water in the developing world. Environ Sci Technol 42: 4261–4267.
Clasen TF, 2009. Scaling Up Household Water Treatment among Low-Income Populations. Geneva, Switzerland: World Health Organization.
United States Agency for International Development and Centers for Disease Control and Prevention, 2010. Household Water Treatment Options in Developing Countries: Slow Sand Filtration. Available at: http://sanitationupdates.wordpress.com/2010/11/09/usaidcdc-slow-sand-filtration-fact-sheet/. Accessed November 28, 2010.
Elliott MA, Stauber CE, Koksal F, DiGiano FA, Sobsey MD, 2008. Reductions of E. coli, echovirus type 12 and bacteriophages in an intermittently operated household-scale slow sand filter. Water Res 42: 2662–2670.
Stauber CE, Elliot MA, Koksal F, Ortiz GM, DiGiano FA, Sobsey MD, 2006. Characterization of the biosand filter for E. coli reductions from household drinking water under controlled laboratory and field use conditions. Water Sci Technol 54: 1–7.
Palmateer G, Manz D, Jurkovic A, McInnis R, Unger S, Kwan KK, Dutka BJ, 1999. Toxicant and parasite challenge of Manz intermittent slow sand filter. Environ Toxicol 14: 217–225.
Stauber CE, Ortiz GM, Loomis DP, Sobsey MD, 2009. A randomized controlled trial of the concrete biosand filter and its impact on diarrheal disease in Bonao, Dominican Republic. Am J Trop Med Hyg 80: 286–293.
Tiwari SK, Schmidt WP, Darby J, Kariuki ZG, Jenkins M, 2009. Intermittent slow sand filter for preventing diarrhoea among children in Kenyan households using unimproved water sources: a randomized controlled trial. Trop Med Int Health 14: 1374–1382.
Duke WF, Nordin RN, Baker D, Mazumder A, 2006. The use and performance of BioSand filters in the Artibonite Valley of Haiti: a field study of 107 households. Rural Remote Health 6: 570.
Liang KR, Stauber CE, Sobsey MD, 2009. Independent Evaluation of the Biosand Water Filter in Rural Cambodia: Sustainability, Health Impact and Water Quality Improvement. Washington, DC: World Bank.
Vyas S, Kumaranayake L, 2006. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21: 459–468.
Rabe-Hesketh S, Skrondal A, 2005. Multilevel and Longitudinal Modeling Using Stata. College Station, TX: Stata Press, 101–142.
Wang K, Lee AH, Hamilton G, Yau KKW, 2006. Multilevel logistic regression modeling with correlated random effects: application to the smoking Cessation for Youth study. Stat Med 25: 3864–3876.
Wellin E, 1955. Water boiling in a Peruvian town. Paul BD, ed. Health, Culture, and Community. New York, NY: Russell Sage Foundation, 71–103.
Rogers E, 2003. Diffusion of Innovations, 5th ed. New York, NY: Simon and Schuster.
World Health Organization, 2004. Drinking Water Quality Guidelines, Vol. 1, 3rd ed. Geneva, Switzerland: World Health Organization.
Clasen T, Brown J, Collin S, 2006. Preventing diarrhoea with household ceramic water filters: assessment of a pilot project in Bolivia. Int J Environ Health Res 16: 221–239.
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.
Colindres R, Mermin J, Ezati E, Kambabazi S, Buyungo P, Sekabembe L, Baryarama F, Kitabire F, Mukasa S, Kizito F, Fitzgerald C, Quick R, 2007. Utilization of a basic care and prevention package by HIV-infected persons in Uganda. AIDS Care 20: 139–145.
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 diarrhoea in areas with turbid source water in rural western Kenya: cluster randomized controlled trial. BMJ 331: 478–483.
Luby SP, Mendoza C, Keswick BH, Chiller TM, Hoekstra RM, 2008. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78: 382–387.
Gundry S, Wright J, Conroy R, 2004. A systematic review of health outcomes related to household water quality in developing countries. J Water Health 2: 1–13.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhoea: a systematic review and meta-analysis. BMJ 334: 782.
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.
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The biosand filter (BSF) is a promising point of use (POU) technology for water treatment; however there has been little follow-up of initial implementation to assess sustainability. The purpose of this study was to examine continued use, performance, and sustainability of previously implemented concrete BSFs in Bonao, Dominican Republic. Of 328 households visited and interviewed, 90% of BSFs were still in use after approximately 1 year since installation. Water-quality improvement, measured by fecal indicator bacteria reduction, was found to be 84–88%, which is lower than reductions in controlled laboratory studies but similar to other field assessments. In a short prospective cohort study comparing BSF to non-BSF households, odds of reported diarrheal disease in BSF households were 0.39 times the odds of reported diarrheal disease in non-BSF households. These results document high levels of sustained and effective concrete BSF use and associated improvements in water quality and health.
Financial support: This publication was made possible by the support of the American people through the US Agency for International Development (USAID). It was prepared under the Environmental Health Indefinite Quantity Contract (EHIQC) GHA-I-00-04-00006/Task Order #2, Line Item #3 and managed by CDM International Inc. Laboratory supplies for water-quality testing were donated by IDEXX Laboratories and Hach Company. We are grateful to the Bonao Rotary Club and the Canadian Embassy of the Dominican Republic for their generous financial support of this study.
Authors' addresses: Benjamin A. Aiken and Mark D. Sobsey, Department of Environmental Sciences and Engineering, University of North Carolina—Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, E-mails: benjamin_aiken@med.unc.edu and mark_sobsey@unc.edu. Christine E. Stauber, Institute of Public Health, Georgia State University, Atlanta, GA, E-mail: cstauber@gsu.edu. Gloria M. Ortiz, Department of Internal Medicine, Bronx Lebanon Hospital Center, Bronx, NY, E-mail: gortiz1@bronxleb.org.
World Health Organization and United Nations Children's Fund, 2010. Progress on Sanitation and Drinking Water 2010 Update. Available at: http://www.who.int/water_sanitation_health/publications/9789241563956/en/index.html. Accessed June 25, 2010.
World Health Organization, 2008. Household Water Treatment and Safe Storage. Available at: http://www.who.int/household_water/en/index.html. Accessed June 9, 2008.
Sobsey MD, 2002. Managing Water in the Home: Accelerated Health Gains from Improved Water Supply. Geneva, Switzerland: World Health Organization.
Schmidt WP, Cairncross S, 2009. Household water treatment in poor populations: is there enough evidence for scaling up now. Environ Sci Technol 43: 986–992.
Rose A, Roy S, Abraham V, Holmgren G, George K, Balraj V, Abraham S, Muliyil J, Joseph A, Kang G, 2006. Solar disinfection of water for diarrhoeal prevention in southern India. Arch Dis Child 91: 139–141.
Rainey RC, Harding AK, 2005. Acceptability of solar disinfection of drinking water treatment in Kathmandu Valley, Nepal. Int J Environ Res Public Health 15: 361–372.
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.
Brown J, Sobsey M, Proum S, 2007. Use of Ceramic Water Filters in Cambodia. Available at: http://www.wsp.org/UserFiles/file/926200724252_eap_cambodia_filter.pdf. Accessed February 23, 2009.
Hunter PR, 2009. Household water treatment in developing countries: comparing different intervention types using meta-regression. Environ Sci Technol 43: 8991–8997.
Sobsey MD, Stauber CE, Casanova LM, Brown JM, Elliot MA, 2008. Point of use household drinking water filtration: a practical, effective solution for providing sustained access to safe drinking water in the developing world. Environ Sci Technol 42: 4261–4267.
Clasen TF, 2009. Scaling Up Household Water Treatment among Low-Income Populations. Geneva, Switzerland: World Health Organization.
United States Agency for International Development and Centers for Disease Control and Prevention, 2010. Household Water Treatment Options in Developing Countries: Slow Sand Filtration. Available at: http://sanitationupdates.wordpress.com/2010/11/09/usaidcdc-slow-sand-filtration-fact-sheet/. Accessed November 28, 2010.
Elliott MA, Stauber CE, Koksal F, DiGiano FA, Sobsey MD, 2008. Reductions of E. coli, echovirus type 12 and bacteriophages in an intermittently operated household-scale slow sand filter. Water Res 42: 2662–2670.
Stauber CE, Elliot MA, Koksal F, Ortiz GM, DiGiano FA, Sobsey MD, 2006. Characterization of the biosand filter for E. coli reductions from household drinking water under controlled laboratory and field use conditions. Water Sci Technol 54: 1–7.
Palmateer G, Manz D, Jurkovic A, McInnis R, Unger S, Kwan KK, Dutka BJ, 1999. Toxicant and parasite challenge of Manz intermittent slow sand filter. Environ Toxicol 14: 217–225.
Stauber CE, Ortiz GM, Loomis DP, Sobsey MD, 2009. A randomized controlled trial of the concrete biosand filter and its impact on diarrheal disease in Bonao, Dominican Republic. Am J Trop Med Hyg 80: 286–293.
Tiwari SK, Schmidt WP, Darby J, Kariuki ZG, Jenkins M, 2009. Intermittent slow sand filter for preventing diarrhoea among children in Kenyan households using unimproved water sources: a randomized controlled trial. Trop Med Int Health 14: 1374–1382.
Duke WF, Nordin RN, Baker D, Mazumder A, 2006. The use and performance of BioSand filters in the Artibonite Valley of Haiti: a field study of 107 households. Rural Remote Health 6: 570.
Liang KR, Stauber CE, Sobsey MD, 2009. Independent Evaluation of the Biosand Water Filter in Rural Cambodia: Sustainability, Health Impact and Water Quality Improvement. Washington, DC: World Bank.
Vyas S, Kumaranayake L, 2006. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21: 459–468.
Rabe-Hesketh S, Skrondal A, 2005. Multilevel and Longitudinal Modeling Using Stata. College Station, TX: Stata Press, 101–142.
Wang K, Lee AH, Hamilton G, Yau KKW, 2006. Multilevel logistic regression modeling with correlated random effects: application to the smoking Cessation for Youth study. Stat Med 25: 3864–3876.
Wellin E, 1955. Water boiling in a Peruvian town. Paul BD, ed. Health, Culture, and Community. New York, NY: Russell Sage Foundation, 71–103.
Rogers E, 2003. Diffusion of Innovations, 5th ed. New York, NY: Simon and Schuster.
World Health Organization, 2004. Drinking Water Quality Guidelines, Vol. 1, 3rd ed. Geneva, Switzerland: World Health Organization.
Clasen T, Brown J, Collin S, 2006. Preventing diarrhoea with household ceramic water filters: assessment of a pilot project in Bolivia. Int J Environ Health Res 16: 221–239.
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.
Colindres R, Mermin J, Ezati E, Kambabazi S, Buyungo P, Sekabembe L, Baryarama F, Kitabire F, Mukasa S, Kizito F, Fitzgerald C, Quick R, 2007. Utilization of a basic care and prevention package by HIV-infected persons in Uganda. AIDS Care 20: 139–145.
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 diarrhoea in areas with turbid source water in rural western Kenya: cluster randomized controlled trial. BMJ 331: 478–483.
Luby SP, Mendoza C, Keswick BH, Chiller TM, Hoekstra RM, 2008. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78: 382–387.
Gundry S, Wright J, Conroy R, 2004. A systematic review of health outcomes related to household water quality in developing countries. J Water Health 2: 1–13.
Clasen T, Schmidt WP, Rabie T, Roberts I, Cairncross S, 2007. Interventions to improve water quality for preventing diarrhoea: a systematic review and meta-analysis. BMJ 334: 782.
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.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 56 | 56 | 6 |
Full Text Views | 485 | 136 | 2 |
PDF Downloads | 196 | 31 | 0 |