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Household based treatment of drinking water with flocculant-disinfectant for preventing diarrhoea in areas with turbid source water in rural western Kenya: cluster randomised controlled trial.

Abstract：

OBJECTIVE:To compare the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculant-disinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. DESIGN:Cluster randomised controlled trial over 20 weeks. SETTING:Family compounds, each containing several houses, in rural western Kenya. PARTICIPANTS:6650 people in 605 family compounds. INTERVENTION:Water treatment: flocculant-disinfectant, sodium hypochlorite, and usual practice (control). MAIN OUTCOME MEASURES:Prevalence of diarrhoea and all cause mortality. Escherichia coli concentration, free residual chlorine concentration, and turbidity in household drinking water as surrogates for effectiveness of water treatment. RESULTS:In children < 2 years old, compared with those in the control compounds, the absolute difference in prevalence of diarrhoea was -25% in the flocculant-disinfectant arm (95% confidence interval -40 to -5) and -17% in the sodium hypochlorite arm (-34 to 4). In all age groups compared with control, the absolute difference in prevalence was -19% in the flocculant-disinfectant arm (-34 to -2) and -26% in the sodium hypochlorite arm (-39 to -9). There were significantly fewer deaths in the intervention compounds than in the control compounds (relative risk of death 0.58, P = 0.036). Fourteen per cent of water samples from control compounds had E coli concentrations < 1 CFU/100 ml compared with 82% in flocculant-disinfectant and 78% in sodium hypochlorite compounds. The mean turbidity of drinking water was 8 nephelometric turbidity units (NTU) in flocculant-disinfectant households, compared with 55 NTU in the two other compounds (P < 0.001). CONCLUSIONS:In areas of turbid water, flocculant-disinfectant was associated with a significant reduction in diarrhoea among children < 2 years. This health benefit, combined with a significant reduction in turbidity, suggests that the flocculant-disinfectant is well suited to areas with highly contaminated and turbid water.

journal_name

BMJ

journal_title

BMJ (Clinical research ed.)

authors

Crump JA,Otieno PO,Slutsker L,Keswick BH,Rosen DH,Hoekstra RM,Vulule JM,Luby SP

doi

10.1136/bmj.38512.618681.E0

keywords:

subject

Has Abstract

pub_date

2005-09-03 00:00:00

pages

478

issue

7515

eissn

0959-8138

issn

1756-1833

pii

bmj.38512.618681.E0

journal_volume

331

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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Household based treatment of drinking water with flocculant-disinfectant for preventing diarrhoea in areas with turbid source water in rural western Kenya: cluster randomised controlled trial.