Natural Resources and the Environment, CSIR, P.O. Box 395, Pretoria, South Africa.
Environ Sci Technol. 2011 Nov 1;45(21):9315-23. doi: 10.1021/es2018835. Epub 2011 Oct 5.
We report the results of a randomized controlled intervention study (September 2007 to March 2009) investigating the effect of solar disinfection (SODIS) of drinking water on the incidence of dysentery, nondysentery diarrhea, and anthropometric measurements of height and weight among children of age 6 months to 5 years living in peri-urban and rural communities in Nakuru, Kenya. We compared 555 children in 404 households using SODIS with 534 children in 361 households with no intervention. Dysentery was recorded using a pictorial diary. Incidence rate ratios (IRR) for both number of days and episodes of dysentery and nondysentery diarrhea were significantly (P < 0.001) reduced by use of solar disinfection: dysentery days IRR = 0.56 (95% CI 0.40 to 0.79); dysentery episodes IRR = 0.55 (95% CI 0.42 to 0.73); nondysentery days IRR = 0.70 (95% CI 0.59 to 0.84); nondysentery episodes IRR = 0.73 (95% CI 0.63 to 0.84). Anthropometry measurements of weight and height showed median height-for-age was significantly increased in those on SODIS, corresponding to an average of 0.8 cm over a 1-year period over the group as a whole (95% CI 0.7 to 1.6 cm, P = 0.031). Median weight-for-age was higher in those on SODIS, corresponding to a 0.23 kg difference in weight over the same period; however, the confidence interval spanned zero and the effect fell short of statistical significance (95% CI -0.02 to 0.47 kg, P = 0.068). SODIS and control households did not differ in the microbial quality of their untreated household water over the follow-up period (P = 0.119), but E. coli concentrations in SODIS bottles were significantly lower than those in storage containers over all follow-up visits (P < 0.001). This is the first trial to show evidence of the effect of SODIS on childhood anthropometry, compared with children in the control group and should alleviate concerns expressed by some commentators that the lower rates of dysentery associated with SODIS are the product of biased reporting rather than reflective of genuinely decreased incidence.
我们报告了一项随机对照干预研究（2007 年 9 月至 2009 年 3 月）的结果，该研究调查了太阳能消毒（SODIS）对肯尼亚奈洛比城乡社区中 6 个月至 5 岁儿童痢疾、非痢疾腹泻以及身高和体重的影响。我们将 404 户家庭中的 555 名儿童与 361 户家庭中的 534 名未接受干预的儿童进行了比较。痢疾使用图片日记记录。使用太阳能消毒的儿童痢疾和非痢疾腹泻天数和发作的发病率比值（IRR）显著降低（P < 0.001）：痢疾天数 IRR = 0.56（95%CI 0.40 至 0.79）；痢疾发作 IRR = 0.55（95%CI 0.42 至 0.73）；非痢疾腹泻天数 IRR = 0.70（95%CI 0.59 至 0.84）；非痢疾腹泻发作 IRR = 0.73（95%CI 0.63 至 0.84）。体重和身高的人体测量学测量显示，接受 SODIS 的儿童身高年龄中位数显著增加，这与整个组在一年期间平均增加 0.8 厘米相对应（95%CI 0.7 至 1.6 厘米，P = 0.031）。接受 SODIS 的儿童体重年龄中位数较高，相当于同期体重差异为 0.23 公斤；然而，置信区间跨越零，效果未达到统计学意义（95%CI -0.02 至 0.47 公斤，P = 0.068）。在随访期间，SODIS 和对照家庭的未处理家庭用水的微生物质量没有差异（P = 0.119），但 SODIS 瓶中的大肠杆菌浓度在所有随访访问中均明显低于储存容器（P < 0.001）。这是第一个证明 SODIS 对儿童人体测量学影响的试验，与对照组的儿童相比，并且应该减轻一些评论员表达的担忧，即与 SODIS 相关的较低痢疾率是有偏见报告的产物，而不是真正发病率降低的反映。
