Department of African-American Studies, Georgia State University, Atlanta, Georgia.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Trop Med Hyg. 2018 May;98(5):1260-1268. doi: 10.4269/ajtmh.17-0731. Epub 2018 Mar 29.
is a leading cause of diarrhea among Kenyan infants. Ceramic water filters (CWFs) are used for household water treatment. We assessed the impact of CWFs on diarrhea, cryptosporidiosis prevention, and water quality in rural western Kenya. A randomized, controlled intervention trial was conducted in 240 households with infants 4-10 months old. Twenty-six weekly household surveys assessed infant diarrhea and health facility visits. Stool specimens from infants with diarrhea were examined for . Source water, filtered water, and filter retentate were tested for and/or microbial indicators. To estimate the effect of CWFs on health outcomes, logistic regression models using generalized estimating equations were performed; odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Households reported using surface water (36%), public taps (29%), or rainwater (17%) as their primary drinking water sources, with no differences in treatment groups. Intervention households reported less diarrhea (7.6% versus 8.9%; OR: 0.86 [0.64-1.16]) and significantly fewer health facility visits for diarrhea (1.0% versus 1.9%; OR: 0.50 [0.30-0.83]). In total, 15% of intervention and 12% of control stools yielded ( = 0.26). was detected in 93% of source water samples; 71% of filtered water samples met World Health Organization recommendations of < 1 /100 mL. was not detected in source water and was detected in just 2% of filter rinses following passage of large volumes of source water. Water quality was improved among CWF users; however, the short study duration and small sample size limited our ability to observe reductions in cryptosporidiosis.
志贺菌是肯尼亚婴儿腹泻的主要病因。陶瓷滤水器(CWF)被用于家庭水处理。我们评估了 CWF 对农村肯尼亚西部腹泻、隐孢子虫病预防和水质的影响。在 240 户有 4-10 个月大婴儿的家庭中进行了一项随机对照干预试验。每周进行 26 次家庭调查,评估婴儿腹泻和卫生机构就诊情况。对腹泻婴儿的粪便标本进行 和/或 微生物指标检测。为了估计 CWF 对健康结果的影响,使用广义估计方程进行了逻辑回归模型分析;报告了比值比(OR)和 95%置信区间(CI)。家庭报告的主要饮用水源包括地表水(36%)、公共水龙头(29%)或雨水(17%),但治疗组之间没有差异。干预家庭报告腹泻(7.6% 对 8.9%;OR:0.86[0.64-1.16])和因腹泻就诊(1.0% 对 1.9%;OR:0.50[0.30-0.83])的次数明显较少。总共有 15%的干预组和 12%的对照组粪便中检出 ( = 0.26)。93%的水源水样中检出 ;71%的过滤水样符合世界卫生组织建议的 < 1 /100 mL。水源中未检出 ,仅在经过大量水源水后,在 2%的滤器冲洗水中检出。CWF 用户的水质得到改善;然而,研究持续时间短且样本量小,限制了我们观察到隐孢子虫病减少的能力。