Tintle Nathan, Heynen Adam, Van De Griend Kristin, Ulrich Rachel, Ojo Matthew, Boven Emma, Brokus Sarah, Wade Randall, Best Aaron A
Department of Mathematics and Statistics, Dordt University, 498 4th Ave NE, Sioux Center, IA 51250 USA.
2Department of Statistics, Montana State University, Bozeman, MT USA.
Trop Med Health. 2019 Aug 7;47:48. doi: 10.1186/s41182-019-0175-4. eCollection 2019.
To develop and evaluate a strategy for reducing the prevalence and impact of waterborne disease, a water quality intervention was developed for Fiji by Give Clean Water, Inc. in partnership with the Fiji Ministry of Health. Residents were provided and trained on how to use a Sawyer® PointONE™ filter, while also being taught proper handwashing techniques. At the time of the filter installation, all households were surveyed inquiring about the prior 2- to 4-week period. Households were measured a second time between 19 and 225 days later (mean = 66 days).
To date, five economic and health outcomes have been tracked on 503 households to evaluate the efficacy of the intervention. When comparing baseline to follow-up among the 503 households, the 2-week diarrhea prevalence decreased in households from 17.5% at baseline to 1.8% at follow-up. Also, the 2-week prevalence of severe diarrhea decreased per household from 9.7% at baseline to 0.6% at follow-up. Finally, monthly diarrhea-related medical costs reduced by an average of Fijian (FJ) $3.54 per person, and monthly water expenses reduced by FJ $0.63 per person. All estimated values are obtained from general linear and logistic mixed-effect models, which adjusted for location, season, time to follow-up, household size, water source, and respondent changing. Changes in economic and health outcomes from installation to follow-up were statistically significant ( < 0.05) in all cases, in both unadjusted and adjusted models.
The installation of water filters shows promise for the reduction of diarrhea prevalence in Fiji, as well as the reduction of diarrhea-related medical costs and water expenses. Future work entails evaluation in other countries and contexts, long-term health monitoring, and comparison to alternative water quality interventions.
为制定和评估一项降低水源性疾病患病率及影响的策略，“提供清洁用水公司”与斐济卫生部合作，为斐济制定了一项水质干预措施。为居民提供了索耶PointONE™过滤器并对其使用方法进行了培训，同时还教授了正确的洗手技巧。在安装过滤器时，对所有家庭进行了调查，询问其前2至4周的情况。在19至225天后（平均66天）对家庭进行了第二次测量。
迄今为止，已对503户家庭的五项经济和健康指标进行了跟踪，以评估干预措施的效果。在503户家庭中比较基线水平和随访结果时，家庭两周腹泻患病率从基线时的17.5%降至随访时的1.8%。此外，每户家庭严重腹泻的两周患病率从基线时的9.7%降至随访时的0.6%。最后，每月与腹泻相关的医疗费用人均平均减少3.54斐济元，每月水费人均减少0.63斐济元。所有估计值均来自一般线性和逻辑混合效应模型，这些模型对地点、季节、随访时间、家庭规模、水源和受访者变化进行了调整。在未调整和调整后的模型中，从安装到随访期间经济和健康指标的变化在所有情况下均具有统计学意义（<0.05）。
安装滤水器有望降低斐济的腹泻患病率，以及与腹泻相关的医疗费用和水费。未来的工作需要在其他国家和环境中进行评估、长期健康监测，并与其他水质干预措施进行比较。
