Kirby Miles A, Nagel Corey L, Rosa Ghislaine, Umupfasoni Marie Mediatrice, Iyakaremye Laurien, Thomas Evan A, Clasen Thomas F
London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom; Emory University Rollins School of Public Health,1518 Clifton Road, NE, Atlanta, GA 30322, USA.
Oregon Health and Science University, School of Nursing Portland Campus,3455 SW US Veterans Hospital Road, SN-6S, Portland, OR 97239, USA.
Int J Hyg Environ Health. 2017 Aug;220(6):1020-1029. doi: 10.1016/j.ijheh.2017.05.013. Epub 2017 Jun 1.
Unsafe drinking water is a substantial health risk contributing to child diarrhoea. We investigated impacts of a program that provided a water filter to households in rural Rwandan villages. We assessed drinking water quality and reported diarrhoea 12-24 months after intervention delivery among 269 households in the poorest tertile with a child under 5 from 9 intervention villages and 9 matched control villages. We also documented filter coverage and use. In Round 1 (12-18 months after delivery), 97.4% of intervention households reported receiving the filter, 84.5% were working, and 86.0% of working filters contained water. Sensors confirmed half of households with working filters filled them at least once every other day on average. Coverage and usage was similar in Round 2 (19-24 months after delivery). The odds of detecting faecal indicator bacteria in drinking water were 78% lower in the intervention arm than the control arm (odds ratio (OR) 0.22, 95% credible interval (CrI) 0.10-0.39, p<0.001). The intervention arm also had 50% lower odds of reported diarrhoea among children <5 than the control arm (OR=0.50, 95% CrI 0.23-0.90, p=0.03). The protective effect of the filter is also suggested by reduced odds of reported diarrhoea-related visits to community health workers or clinics, although these did not reach statistical significance.
不安全饮用水对健康构成重大风险，会导致儿童腹泻。我们调查了一个向卢旺达农村村庄家庭提供滤水器的项目的影响。我们评估了饮用水质量，并报告了在干预实施12至24个月后，来自9个干预村庄和9个匹配对照村庄的最贫困三分位中269户有5岁以下儿童家庭的腹泻情况。我们还记录了滤水器的覆盖率和使用情况。在第一轮（交付后12至18个月），97.4%的干预家庭报告收到了滤水器，84.5%的滤水器可正常使用，86.0%可正常使用的滤水器中有水。传感器确认，平均每隔一天至少有一半拥有可正常使用滤水器的家庭会对滤水器进行装水。第二轮（交付后19至24个月）的覆盖率和使用率情况类似。干预组饮用水中检测到粪便指示菌的几率比对照组低78%（优势比（OR）0.22，95%可信区间（CrI）0.10 - 0.39，p<0.001）。干预组5岁以下儿童报告腹泻的几率也比对照组低50%（OR = 0.50，95% CrI 0.23 - 0.90，p = 0.03）。尽管未达到统计学显著性，但滤水器对报告的与腹泻相关的社区卫生工作者就诊或诊所就诊几率的降低也表明了其保护作用。
