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Differences in Field Effectiveness and Adoption between a Novel Automated Chlorination System and Household Manual Chlorination of Drinking Water in Bangladesh

4 March 2015 10:08 (America/New_York)

Differences in Field Effectiveness and Adoption between a Novel Automated Chlorination System and Household Manual Chlorination of Drinking Water in Dhaka, Bangladesh: A Randomized Controlled Trial. PLoS ONE, Mar 2015.

Authors: Amy J. Pickering , Yoshika Crider, Nuhu Amin, Valerie Bauza, Leanne Unicomb, Jennifer Davis, Stephen P. Luby

The number of people served by networked systems that supply intermittent and contaminated drinking water is increasing. In these settings, centralized water treatment is ineffective, while household-level water treatment technologies have not been brought to scale.

This study compares a novel low-cost technology designed to passively (automatically) dispense chlorine at shared handpumps with a household-level intervention providing water disinfection tablets (Aquatab), safe water storage containers, and behavior promotion. Twenty compounds were enrolled in Dhaka, Bangladesh, and randomly assigned to one of three groups: passive chlorinator, Aquatabs, or control. Over a 10-month intervention period, the mean percentage of households whose stored drinking water had detectable total chlorine was 75% in compounds with access to the passive chlorinator, 72% in compounds receiving Aquatabs, and 6% in control compounds.

Both interventions also significantly improved microbial water quality. Aquatabs usage fell by 50% after behavioral promotion visits concluded, suggesting intensive promotion is necessary for sustained uptake. The study findings suggest high potential for an automated decentralized water treatment system to increase consistent access to clean water in low-income urban communities.

Safe Water: It’s a Human Right

24 February 2015 14:10 (America/New_York)

Safe Water: It’s a Human Right, 2015.

Syed Emdadul Haque1,2 | Atsuro Tsutsumi1, | Capon Anthony1

1United Nations University International Institute for Global Health (UNU-IIGH)UNU-IIGH Building, UKM Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak,Cheras 56000, Kuala Lumpur, MALAYSIA

2 UChicago Research Bangladesh, Dhaka, Bangladesh.

Already 2–3 billion people lack any access to safe drinking water and 884 million more are without sufficient access to a suitable water source, and yet, the situation could worsen still, (link). Indeed, without significant changes, two-thirds of the world’s population is expected to be living under “severe water stress conditions” by 2025, (link). Severe water stress is when there is less than 1,000 cubic meters of water available per person in a given year. This is an alarming prospect for the world’s population.

Recently published an article where vice minister at the Ministry of Water Recourses, China highlighted that about two-thirds of Chinese cities are “water needy” and nearly 300 million rural people have lack of access to drinking safe water, (link). In addition that, The National Intelligence Council (NIC) reported that “Global Trends 2030: Alternative Worlds” states that, with regard to China, “climate change, urbanization trends and middle-class lifestyles will create huge water demand and crop shortages by 2030.”

These demand and crisis can create big economic, health, and social problems. According to the Ministry of Supervision, about 60,000 premature deaths already are happening due to water pollution accidents annually. Therefore, experts say that Govt. should give more effort for rational use of water and control its pollution.

Water scarcity continues to pose the greatest challenge in the developing world. Even though “water is life”, safe water is very costly. Although large infrastructure-intensive water systems are prevalent in industrialized countries, for many developing nations such systems are too expensive to install and operate. For example, the United States spends about US$29 billion every year (link) to maintain its water and wastewater plants and it is obvious that the developing world does not have the kind of money it takes to provide safe water for its population.

Climate change and impacts on safe water

In many countries, climate change is another factor impacting safe water supplies. Water is a key medium through which climate change affects human populations and ecosystems, especially because of expected changes in water quality and quantity, notes the United Nations Expert on Human Rights, Water and Sanitation, (link). Indeed, in many regions of the world, changes to the supply and quality of freshwater resources resulting from climate change may endanger sustainable development, poverty reduction, and child mortality goals, the Intergovernmental Panel on Climate Change (IPCC) has warned, (link).

IPCC also highlighted that scientist predict nearly one-third of the planet’s land surface will suffer due to extreme drought by the end of this century and 20% of the world population could be affected by severe flooding by 2080. It is therefore essential to consider the direct effects of climate change on water resources as well as its indirect influences on other external drivers of change. Climate change amplifies pressure on governments to deal with the existing threats to the already fragile sustainability of freshwater resources — population growth, socioeconomic and technological changes, and the resulting rising demand for water.

There is considerable variation among the projections and scenarios concerning the impact of climate change on water resources. However, it is clear that it will increase water stress in already dry areas and will undermine water quality in areas flooded by rain or seawater. Also, rising water temperatures, both higher and lower groundwater levels, floods and droughts can all increase the threats from pathogens, chemical substances and radiological hazards in drinking water.

For example, flooding can cause overflows from sewage treatment plants into freshwater sources, which could contaminate certain food crops with pathogen-containing feces, (link). In addition, many scientists predict that sea-level rise can lead to saltwater interruption into groundwater drinking supplies, especially in low-lying, gently sloping coastal areas which will creates scarcity of safe water. On the other hand, droughts affecting agriculture can impact food production and might cause severe malnutrition, (link).

The right to clean water

Access to clean water was declared a human right on 28 July 2010 by the UN General Assembly (A/RES/64/292), receiving 122 votes in favour and zero votes against, (link). The right to water is also implicit in Article 11 of the International Covenant on Economic, Social and Cultural Rights as interpreted by the Committee on Economic, Social and Cultural Rights, which comments that, (link) “the human right to water entitles everyone to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic uses”.

However, safe water is a vital human rights concern in urban slums worldwide. Rapidly growing urbanization and overcrowding increase already heavy demands for fresh water. The Asia-Pacific region is home to 60 percent of the world’s population but it possesses only 36 percent of Earth’s water resources. Water availability, allocation, and quality remain major issues in the Asian region. Access to safe drinking water is limited and water shortages can pose a real threat to the daily life and the health of communities.

For many of those who have access to water, it is either too expensive or not suitable for consumption, often exposed to dangerous levels of biological contaminants and chemical pollutants. This is due in part to inadequate management of urban, industrial, and agricultural wastewater.

Simply put, for many people water is not yet a human right within comprehension. In coming years, water challenges will increase significantly as because of population growth and rising incomes will lead to greater water consumption, as well as more waste. According to the UN World Water Development Report, (link), by 2050 at least one in four people are likely to live in a country affected by chronic or recurring shortages of fresh water.

Access to safe water should therefore no longer be seen as a service, but, since it is a human right, states and organizations must work towards using economic resources and technology to provide safe, clean, accessible and affordable water, particularly in developing countries. Thus, it is urgent to think about the national and global water consumption policy for the decision-makers to tackle the future crisis. In addition, policy-driven researchers may introduce low cost solutions through public private partnerships.

Household Water Treatment and Safe Storage to Prevent Diarrheal Disease in Developing Countries

18 February 2015 10:45 (America/New_York)

Household Water Treatment and Safe Storage to Prevent Diarrheal Disease in Developing Countries. Current Environmental Health Reports, January 2015

Author: Thomas Clasen JD, PhD

Household water treatment and safe storage (HWTS), such as boiling, filtering, or chlorinating water at home, have been shown to be effective in improving the microbiological quality of drinking water. However, estimates of their protective effect against diarrhea, a major killer, have varied widely.

While results may be exaggerated because of reporting bias, this heterogeneity is consistent with other environmental interventions that are implemented with varying levels of coverage and uptake in settings where the source of exposure represents one of many transmission pathways.

Evidence suggests that the effectiveness of HWTS can be optimized by ensuring that the method

  • is microbiologically effective;
  • making it accessible to an exposed population; and
  • securing their consistent and long-term use.

Water bags as a potential vehicle for transmitting disease in a West African capital, Bissau

18 February 2015 10:37 (America/New_York)

Water bags as a potential vehicle for transmitting disease in a West African capital, Bissau. Int. Health (2015) 7 (1): 42-48. doi: 10.1093/inthealth/ihu056, August 27, 2014

Authors: Adriano A. Bordaloa,b,* and Ana Machadoa,b

aLaboratory of Hydrobiology and Ecology, Institute of Biomedical Sciences, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira, 228, 4050–313 Porto, Portugal
bCiimar-Centre of Marine and Environmental Research, Porto, Portugal
↵*Corresponding author: Tel: +351 220428181; Fax: +351 222062284; E-mail:

Background – Street vendors of chilled packaged water have an increasing role in meeting the drinking water demand of people on the move in developing nations. Hygienic conditions can be questionable, and water quality screening scarce or non-existent.

Methods – In order to ascertain the quality of the packaged water sold by street vendors in Bissau, the capital of the Western African country Guinea-Bissau, water bags were screened in 2011 and during the 2012 cholera outbreak for key physical, chemical and microbiological parameters.

Results – Water used to fill the hand-filled hand-tied bags originated from communal tap water and melted ice. All samples (n=36) were microbiologically contaminated, although levels showed a pronounced variability (e.g. 7–493 372 cfu 250 ml−1 for Escherichia coli). In 2012, the fecal contamination levels increased (p<0.05), and Vibrio cholerae was detected in all water bags obtained from the neighborhood where the outbreak started.

Conclusion – Findings showed that all packaged water samples were unfit for human consumption and during the 2012 cholera outbreak represented a potential vehicle for the spread of the disease. The design of measures to decrease the risk associated to the consumption of highly contaminated chilled water is clearly required.

Biosand water filters for floating villages in Cambodia: safe water does not prevent recontamination

18 February 2015 10:33 (America/New_York)

Biosand water filters for floating villages in Cambodia: safe water does not prevent recontamination. Journal of Water, Sanitation and Hygiene for Development, In Press, Uncorrected Proof © IWA Publishing 2015 | doi:10.2166/washdev.2015.120

Authors: K. D. Curry, M. Morgan, S. H. Peang and S. Seang

Bridgewater State University, 131 Summer Street, Bridgewater, MA 02325, USA E-mail: Water for Cambodia, Siem Reap, Cambodia Mahidol University, Bangkok, Thailand. Kulara Water Co. Ltd., Tbaeng Kaeut Village, Siem Reap Province, Cambodia

Water for Cambodia used biosand filters (BSFs) to provide microbiologically safe drinking water for people in Moat Khla floating village in 2010 and 2011. All 189 families use the lake, which by WHO standards is deemed unsafe for drinking water. Surveys from December 2010 to February 2011 compared 40 families using BSFs and 40 families not using BSFs. Over 92% of BSF households and 90% of non-BSF households were using high-risk lake source water (>100 colonies Escherichia coli/100 mL). Only 2.5% of BSF households had filtered water with bacteria in the high-risk range and only 5% of these 40 households showed recontamination in their storage water.

Forty percent of non-BSF households had high-risk bacteria levels in their stored water, and most used no treatment. Storage water for non-BSF families showed a significant reduction in mean log10 E. coli levels compared to their lake source water. Stored water for non-BSF families showed recontamination even for UV-treated water and boiled river water. Recontamination occurs in both groups but is much less for BSF households highlighting the value of proper storage containers used by BSF households and the need for water and sanitation education for floating villages in Cambodia.

Explaining low rates of sustained use of siphon water filter: evidence from follow-up of a randomised controlled trial in Bangladesh

18 February 2015 10:29 (America/New_York)

Explaining low rates of sustained use of siphon water filter: evidence from follow-up of a randomised controlled trial in Bangladesh. Trop Med Intl Health, Jan 2015.

Authors: Nusrat Najnin, Shaila Arman, et al.

Objective – To assess sustained siphon filter usage among a low-income population in Bangladesh and study relevant motivators and barriers.

Methods – After a randomised control trial in Bangladesh during 2009, 191 households received a siphon water filter along with educational messages. Researchers revisited households after 3 and 6 months to assess filter usage and determine relevant motivators and barriers. Regular users were defined as those who reported using the filter most of the time and were observed to be using the filter at follow-up visits. Integrated behavioural model for water, sanitation and hygiene (IBM-WASH) was used to explain factors associated with regular filter use.

Results – Regular filter usage was 28% at the 3-month follow-up and 21% at the 6-month follow-up. Regular filter users had better quality water at the 6-month, but not at the 3-month visit. Positive predictors of regular filter usage explained through IBM-WASH at both times were willingness to pay >US$1 for filters, and positive attitude towards filter use (technology dimension at individual level); reporting boiling drinking water at baseline (psychosocial dimension at habitual level); and Bengali ethnicity (contextual dimension at individual level). Frequently reported barriers to regular filter use were as follows: considering filter use an additional task, filter breakage and time required for water filtering (technology dimension at individual level).

Conclusion – The technological, psychosocial and contextual dimensions of IBM-WASH contributed to understanding the factors related to sustained use of siphon filter. Given the low regular usage rate and the hardware-related problems reported, the contribution of siphon filters to improving water quality in low-income urban communities in Bangladesh is likely to be minimal.

Changing handwashing behaviour in southern Ethiopia: A longitudinal study on infrastructural and commitment interventions

4 February 2015 11:47 (America/New_York)

Changing handwashing behaviour in southern Ethiopia: A longitudinal study on infrastructural and commitment interventionsSoc Sci Med. 2015 Jan;124:103-14. doi: 10.1016/j.socscimed.2014.11.006.

Authors: Contzen N, Meili IH, Mosler HJ.

Improved hand hygiene efficiently prevents the major killers of children under the age of five years in Ethiopia and globally, namely diarrhoeal and respiratory diseases. Effective handwashing interventions are thus in great demand. Evidence- and theory-based interventions, especially when matched to the target population’s needs, are expected to perform better than common practice. To test this hypothesis, we selected two interventions drawing on a baseline questionnaire-study that applied the RANAS (Risk, Attitudes, Norms, Abilities, Self-regulation) approach and focused on the primary caregivers of households in four rural, water-scarce kebeles (smallest administrative units of Ethiopia) in southern Ethiopia (N = 462).

The two interventions were tested in combination with a standard education intervention in a quasi-experiment, as follows: kebele 1, education intervention, namely an f-diagram exercise, (n = 23); kebele 2, education intervention and public-commitment (n = 122); kebele 3, education intervention and tippy-tap-promotion (i.e. handwashing-station-promotion; n = 150); kebele 4, education intervention, public-commitment and tippy-tap-promotion (n = 113).

In kebeles 3 and 4, nearly 100% of the households followed the promotion and invested material and time to construct for themselves a tippy-tap. Three months after intervention termination, the tippy-taps were in use with water and soap being present in up to 83% of the households (kebele 4). Pre-post data analysis on self-reported handwashing revealed that the population-tailored interventions, and especially the tippy-tap-promotion, performed better than the standard education intervention.

Tendencies in observed behaviour and a recently developed implicit self-measure pointed to similar results. Changing people’s hand hygiene is known to be a challenging task, especially in a water-scarce environment. The present project suggests not only to apply theory and evidence to improve handwashing interventions’ effectiveness, but also emphasizes the relevance of tailoring interventions to the target population.

Reactivity in rapidly collected hygiene and toilet spot check measurements: a cautionary note for longitudinal studies.

4 February 2015 11:42 (America/New_York)

Reactivity in rapidly collected hygiene and toilet spot check measurements: a cautionary note for longitudinal studies. Am J Trop Med Hyg. 2015 Jan 7;92(1):159-62. doi: 10.4269/ajtmh.14-0306.

Authors: Arnold BF, Khush RS, et al.

Discreet collection of spot check observations to measure household hygiene conditions is a common measurement technique in epidemiologic studies of hygiene in low-income countries. The objective of this study was to determine whether the collection of spot check observations in longitudinal studies could itself induce reactivity (i.e., change participant behavior). We analyzed data from a 12-month prospective cohort study in rural Tamil Nadu, India that was conducted in the absence of any hygiene or toilet promotion activities.

Our data included hygiene and toilet spot checks from 10,427 household visits. We found substantial evidence of participant reactivity to spot check observations of hygiene practices that were easy to modify on short notice. For example, soap observed at the household’s primary handwashing location increased from 49% at enrollment to 81% by the fourth visit and remained at or above 77% for the remainder of the study.

Comparing willingness to pay for improved drinking-water quality using stated preference methods in rural and urban Kenya

4 February 2015 11:36 (America/New_York)

Comparing willingness to pay for improved drinking-water quality using stated preference methods in rural and urban kenya. Appl Health Econ Health Policy. 2015 Feb;13(1):81-94. doi: 10.1007/s40258-014-0137-2.

Authors: Brouwer R1, Job FC, van der Kroon B, Johnston R.

BACKGROUND: Access to safe drinking water has been on the global agenda for decades. The key to safe drinking water is found in household water treatment and safe storage systems.

OBJECTIVE: In this study, we assessed rural and urban household demand for a new gravity-driven membrane (GDM) drinking-water filter.

METHODS: A choice experiment (CE) was used to assess the value attached to the characteristics of a new GDM filter before marketing in urban and rural Kenya. The CE was followed by a contingent valuation (CV) question. Differences in willingness to pay (WTP) for the same filter design were tested between methods, as well as urban and rural samples.

RESULTS: The CV follow-up approach produces more conservative and statistically more efficient WTP values than the CE, with only limited indications of anchoring. The effect of the new filter technology on children with diarrhea is among the most important drivers behind choice behavior and WTP in both areas. The urban sample is willing to pay more in absolute terms than the rural sample irrespective of the valuation method. Rural households are more price sensitive, and willing to pay more in relative terms compared with disposable household income.

CONCLUSION: A differentiated marketing strategy across rural and urban areas is expected to increase uptake and diffusion of the new filter technology.

Cor Dietvorst/IRC – The different world water crisis

4 February 2015 11:29 (America/New_York)

Cor Dietvorst/IRC – The different world water crisis | Source: IRC, Jan 2015

The greatest risk that will impact the world today is a decline in freshwater quality and quantity. At least, that’s what the World Economic Forum (WEF) concluded when they quizzed 900 experts for the 2015 Global Risks report [1]. But there’s a different world water crisis to the one the WEF talks about. “Systems that should give people access to safe water and sanitation either don’t exist or are breaking down, on a massive scale, across the world” [2].

Crisis? What crisis?
The WEF report assesses the likelihood and potential impact of 28 global risks and their interconnections over a period of 10 years. While water crises came eighth in the top 10 risks in terms of likelihood, they topped the list in terms of impact, ahead of the spread of infectious diseases, interstate conflict and failure of climate change adaptation. Unsafe drinking water and drought will damage human health and economic activity, the report says. The nexus of water, food, energy and climate change “is one of the overarching megatrends that will shape the world in 2030” [3].

Unlike droughts, floods and oil spills, non-functioning water and sanitation systems seldom make the headlines. Few people are aware that “one in three rural water systems in the developing world are not working” [2] or that many toilets built with government and donor funding are never used. Check out the “sad statistics” of water point and sanitation failures compiled by Susan Davis [4,5].

Solutions for “sad statistics”
Luckily, there seems to some sort of consensus that leadership is needed to solve both the water quality/quantity crisis and the “other crisis” related to the failure of services. In a series of blogs published last year, IRC CEO Patrick Moriarty discusses why government leadership and public financing are crucial to creating water and sanitation services that last: read Tools for lifeThe elephant in the room; and No more fairy tales.


Randomized Controlled Trials in Environmental Health Research: Unethical or Underutilized?

14 January 2015 15:08 (America/New_York)

Randomized Controlled Trials in Environmental Health Research: Unethical or Underutilized? PLoS Med, Jan 2015.

Authors: Ryan W. Allen , Prabjit K. Barn, Bruce P. Lanphear

Randomized controlled trials are standard practice in clinical and pharmaceutical research but have not been embraced by environmental health researchers. Greater use of the RCT design would complement the tremendous contributions made by other methods—including both observational epidemiology and toxicology—to our understanding of environmental risks and the development of environmental health policy.

Researchers, academic institutions, and funding agencies have a role to play in expanding the use of RCTs in environmental health research. Researchers should think creatively about potential interventions and consider the RCT as a possible study design to test their specific research question. Funding agencies should allocate money specifically for randomized studies of environmental interventions.

In addition to its scientific advantages, this would provide the additional benefit of encouraging research that aims not only to identify problems but also to identify possible solutions. Ethical issues must be considered carefully, and while institutional ethics approval is necessary, it is not sufficient to ensure that the research is conducted ethically. The RCT design has important limitations and is not applicable to all research questions, so observational studies will, and should, remain the workhorse in environmental health research.

Nevertheless, RCTs can help advance the field of environmental health by creating new knowledge of exposure–health relationships, providing more definitive evidence of causality, identifying efficacious interventions to reduce or eliminate exposure and health risks, and countering the perception that environmental risks are evaluated with inadequate rigor.

A rapid assessment of drinking water quality in informal settlements after a cholera outbreak in Nairobi, Kenya

14 January 2015 14:58 (America/New_York)

A rapid assessment of drinking water quality in informal settlements after a cholera outbreak in Nairobi, Kenya. Journal of Water and Health, In Press, Uncorrected Proof, 2014 | doi:10.2166/wh.2014.173

Authors – Elizabeth Blanton, Natalie Wilhelm, Ciara O’Reilly, Everline Muhonja, Solomon Karoki, Maurice Ope, Daniel Langat, Jared Omolo, Newton Wamola, Joseph Oundo, Robert Hoekstra, Tracy Ayers, Kevin De Cock, Robert Breiman, Eric Mintz and Daniele Lantagne

Populations living in informal settlements with inadequate water and sanitation infrastructure are at risk of epidemic disease. In 2010, we conducted 398 household surveys in two informal settlements in Nairobi, Kenya with isolated cholera cases. We tested source and household water for free chlorine residual (FCR) and Escherichia coli in approximately 200 households. International guidelines are ≥0.5 mg/L FCR at source, ≥0.2 mg/L at household, and <1 E. coli/100 mL.

In these two settlements, 82–38% of water sources met FCR guidelines; and, 7% and 8% were contaminated with E. coli, respectively. In household stored water, 82% and 35% met FCR guidelines and 11% and 32% were contaminated with E. coli, respectively. Source water FCR ≥0.5 mg/L (p = 0.003) and reported purchase of a household water treatment product (p = 0.002) were associated with increases in likelihood that household stored water had ≥0.2 mg/L FCR; which was associated with a lower likelihood of E. coli contamination (p < 0.001).

These results challenge the assumption that water quality in informal settlements is universally poor and the route of disease transmission, and highlight that providing centralized water with ≥0.5 mg/L FCR or (if not feasible) household water treatment technologies reduces the risk of waterborne cholera transmission in informal settlements.

Josh Kearns – Biochar for Control of Trace Contaminants in Water (Video)

14 January 2015 14:46 (America/New_York)

Uploaded on Dec 30, 2014 – Toxic synthetic chemicals such as pesticides and pharmaceutical residues are a major threat to drinking water safety worldwide. Unfortunately, major international water development initiatives focus exclusively on microbial pathogens (the most immediate threat to health) while neglecting synthetic chemical toxins. Low-cost, environmentally sustainable and locally managed treatment technologies are needed to protect human health in impoverished, rural and remote communities.

Our ongoing research demonstrates the potential of char made from surplus biomass (biochar) as an effective sorbent for chemical toxins. We have shown that highly adsorbing biochar can be produced from surplus biomass using low-tech, efficient and environmentally friendly gasifier drum ovens. Our work advances sustainable and locally managed treatment systems employing adsorbent biochar as an effective, affordable and accessible means for providing drinking water that is microbiologically and chemically safe to households and communities in remote and impoverished regions of the world.

Hand-to-mouth contacts result in greater ingestion of feces than dietary water consumption in Tanzania

14 January 2015 14:42 (America/New_York)

Hand-to-mouth contacts result in greater ingestion of feces than dietary water consumption in Tanzania: A quantitative fecal exposure assessment model. Environ. Sci. Technol., DOI: 10.1021/es505555f, Publication Date (Web): January 5, 2015

Authors: Mia Catharine Morgan Mattioli , Jennifer Davis , and Alexandria B. Boehm

Diarrheal diseases kill 1800 children under the age of five die each day, and nearly half of these deaths occur in sub-Saharan Africa. Contaminated drinking water and hands are two important environmental transmission routes of diarrhea-causing pathogens to young children in low-income countries. The objective of this research is to evaluate the relative contribution of these two major exposure pathways in a low-income country setting. A Monte Carlo simulation was used to model the amount of human feces ingested by children under five years old from exposure via hand-to-mouth contacts and stored drinking water ingestion in Bagamoyo, Tanzania.

Child specific exposure data were obtained from the USEPA 2011 Exposure Factors Handbook, and fecal contamination was estimated using hand rinse and stored water fecal indicator bacteria concentrations from over 1200 Tanzanian households. The model outcome is a distribution of a child’s daily dose of feces via each exposure route.

The model results show that Tanzanian children ingest a significantly greater amount of feces each day from hand-to-mouth contacts than from drinking water, which may help elucidate why interventions focused on water without also addressing hygiene often see little to no effect on reported incidence of diarrhea.

Critical parameters in the production of ceramic pot filters for household water treatment in developing countries

31 December 2014 10:33 (America/New_York)

Critical parameters in the production of ceramic pot filters for household water treatment in developing countriesJournal of Water and Health, In Press, Uncorrected Proof © IWA Publishing 2014 | doi:10.2166/wh.2014.090

A. I. A. Soppe, S. G. J. Heijman, I. Gensburger, A. Shantz, D. van Halem, J. Kroesbergen, G. H. Wubbels and P. W. M. H. Smeets

Aqua for All Foundation, Koningskade 40, The Hague 2596 AA, the Netherlands E-mail:
Department of Water Management, Delft University of Technology, Stevinweg 1, Delft 2628 CN, the Netherlands
Engineers Without Borders Australia, 99 Howard Street, North Melbourne, VIC, Australia and Downer Ltd., 133 Main South Road, PO Box 13031, Dunedin 9052, New Zealand
Resource Development International Cambodia, No. 50A, Phum Prek Thom Sangkat Kbal Koh, Khan Mean Chey, Phnom Penh, Kingdom of Cambodia
Het Waterlaboratorium, J.W. Lucasweg 2, Haarlem 2031 BE, the Netherlands
Waterlaboratorium Noord, Rijksstraatweg 85, Glimmen 9756 AD, the Netherlands
KWR Watercycle Research Institute, Groningenhaven 7, Nieuwegein 3433 PE, the Netherlands

The need to improve the access to safe water is generally recognized for the benefit of public health in developing countries. This study’s objective was to identify critical parameters which are essential for improving the performance of ceramic pot filters (CPFs) as a point-of-use water treatment system. Defining critical production parameters was also relevant to confirm that CPFs with high-flow rates may have the same disinfection capacity as pots with normal flow rates. A pilot unit was built in Cambodia to produce CPFs under controlled and constant conditions.

Pots were manufactured from a mixture of clay, laterite and rice husk in a small-scale, gas-fired, temperature-controlled kiln and tested for flow rate, removal efficiency of bacteria and material strength. Flow rate can be increased by increasing pore sizes and by increasing porosity. Pore sizes were increased by using larger rice husk particles and porosity was increased with larger proportions of rice husk in the clay mixture.

The main conclusions are larger pore size decreases the removal efficiency of bacteria; higher porosity does not affect the removal efficiency of bacteria, but does influence the strength of pots; flow rates of CPFs can be raised to 10–20 L/hour without a significant decrease in bacterial removal efficiency.

Microbial quality of domestic water: following the contamination chain in a rural township in Kenya

31 December 2014 10:25 (America/New_York)

Microbial quality of domestic water: following the contamination chain in a rural township in Kenya. Journal of Water, Sanitation and Hygiene for Development, In Press, Uncorrected Proof © IWA Publishing 2014 | doi:10.2166/washdev.2014.070

Authors: Pauline W. Macharia, Paul T. Yillia, Wairimu A. Muia, Denis Byamukama and Norbert Kreuzinger

Department of Biological Sciences, Egerton University, Njoro Campus, P.O. Box 536-20115 Egerton, Kenya E-mail:
International Institute for Applied Systems Analysis, Schlossplatz 1, Laxenburg A-2361, Austria
WSS Services (U) Ltd, P.O. Box 27755 Kampala, Uganda
Resources & Waste Management, Vienna University of Technology, Institute for Water Quality, Karlsplatz 13/226 Vienna, Austria

A study was undertaken in Njoro Township, Kenya to evaluate the extent to which drinking water was subjected to post-collection faecal contamination in low-income and high-income households. Boreholes were the main drinking water sources, accounting for roughly 70% singular access. The microbial quality of drinking water from the boreholes deteriorated from the point-of-collection through conveying containers of small-scale water vendors to household storage containers, irrespective of their income status.

The densities of Escherichia coli (EC) were relatively low at the point-of-collection – median (M): 18 CFU/100 mL, range (R): 0–220, n = 60 – increasing considerably in the containers of water vendors (M: 290 CFU/100 mL, R: 30–350) and slightly (M: 360 CFU/100 mL, R: 0–520) between vendors and low-income households, many of whom used the services of vendors unlike high-income households who relied on a piped system on premises (M: 40 CFU/100 mL, R: 0–500).

Post-collection contamination was high in low-income households compared to high-income households but differences were not significant between the two household categories with and without household water treatment (HWT). Different HWT methods in the two household categories significantly reduced faecal contamination, but unhygienic handling and poor storage practices afterwards caused recontamination. HWT and behavioural change measures need not selectively target household groups solely on the basis of their income status.

Assessing the Consistency and Microbiological Effectiveness of Household Water Treatment Practices by Urban and Rural Populations Claiming to Treat Their Water at Home

31 December 2014 10:09 (America/New_York)

Assessing the Consistency and Microbiological Effectiveness of Household Water Treatment Practices by Urban and Rural Populations Claiming to Treat Their Water at Home: A Case Study in Peru. PLoS One, Dec 2014.

Authors: Ghislaine Rosa, Maria L. Huaylinos, Ana Gil, Claudio Lanata, Thomas Clasen

Background - Household water treatment (HWT) can improve drinking water quality and prevent disease if used correctly and consistently by vulnerable populations. Over 1.1 billion people report treating their water prior to drinking it. These estimates, however, are based on responses to household surveys that may exaggerate the consistency and microbiological performance of the practice—key factors for reducing pathogen exposure and achieving health benefits. The objective of this study was to examine how HWT practices are actually performed by households identified as HWT users, according to international monitoring standards.

Methods and Findings - We conducted a 6-month case study in urban (n = 117 households) and rural (n = 115 households) Peru, a country in which 82.8% of households report treating their water at home. We used direct observation, in-depth interviews, surveys, spot-checks, and water sampling to assess water treatment practices among households that claimed to treat their drinking water at home. While consistency of reported practices was high in both urban (94.8%) and rural (85.3%) settings, availability of treated water (based on self-report) at time of collection was low, with 67.1% and 23.0% of urban and rural households having treated water at all three sampling visits. Self-reported consumption of untreated water in the home among adults and children <5 was common and this was corroborated during home observations. Drinking water of self-reported users was significantly better than source water in the urban setting and negligible but significantly better in the rural setting. However, only 46.3% and 31.6% of households had drinking water <1 CFU/100 mL at all follow-up visits.

Conclusions - Our results raise questions about the usefulness of current international monitoring of HWT practices and their usefulness as a proxy indicator for drinking water quality. The lack of consistency and sub-optimal microbiological effectiveness also raises questions about the potential of HWT to prevent waterborne diseases.

Need for certification of household water treatment products: examples from Haiti

10 December 2014 11:09 (America/New_York)

Need for certification of household water treatment products: examples from Haiti. Trop Med Int Health. 2014 Dec 1. doi: 10.1111/tmi.12445.

Authors: Murray A1, Pierre-Louis J, Joseph F, Sylvain G, Patrick M, Lantagne D. Author information: 1Tufts University Civil and Environmental Engineering, Department.Medford, MA, USA.

OBJECTIVE: To evaluate four chemical treatment products currently seeking approval in Haiti.

METHODS: Household water treatment (HWT) products were evaluated at the certification process validation stage by verifying international product certifications confirming treatment efficacy and reviewing laboratory efficacy data against WHO HWT microbiological performance targets; and at the approval stage by confirming product composition, evaluating treated water chemical content against national and international drinking water quality guidelines, and reviewing packaging for dosing ability and usage directions in Creole.

RESULTS: None of the four evaluated products fulfilled validation or approval stage requirements. None was certified by an international agency as efficacious for drinking water treatment, and none had data demonstrating its ability to meet WHO HWT performance targets. All product sample compositions differed from labeled composition by >20%, and no packaging included complete usage directions in Creole.

CONCLUSIONS: Product manufacturers provided information that was inapplicable, did not demonstrate product efficacy, and was insufficient to ensure safe product use. Capacity building is needed with country regulatory agencies to objectively evaluate HWT products. Products should be internationally assessed against WHO performance targets and also locally approved, considering language, culture, and usability, to ensure effective HWT. This article is protected by copyright. All rights reserved.

Influence of solar water disinfection on immunity against cholera

10 December 2014 11:04 (America/New_York)

Influence of solar water disinfection on immunity against cholera – a review. Journal of Water and Health Vol 12 No 3 pp 393–398 2014.

Authors: Cornelius Cano Ssemakalu, Eunice Ubomba-Jaswa, Keolebogile Shirley Motaung and Michael Pillay.
Faculty of Applied and Computer Sciences, Vaal University of Technology, Vanderbijlpark 1900, South Africa E-mail: Council for Scientific and Industrial Research, Natural Resource and the Environment, P.O. Box 395, Pretoria 0001, South Africa. Department of Biomedical Sciences, Tshwane University of Technology, 175 Nelson Mandela Drive, Arcadia Campus, Pretoria 0001, South Africa

Cholera remains a problem in developing countries. This is attributed to the unavailability of proper water treatment, sanitary infrastructure and poor hygiene. As a consequence, countries facing cholera outbreaks rely on interventions such as the use of oral rehydration therapy and antibiotics to save lives. In addition to vaccination, the provision of chlorine tablets and hygiene sensitization drives have been used to prevent new cholera infections. The implementation of these interventions remains a challenge due to constraints associated with the cost, ease of use and technical knowhow. These challenges have been reduced through the use of solar water disinfection (SODIS). The success of SODIS in mitigating the risk associated with the consumption of waterborne pathogens has been associated with solar irradiation. This has prompted a lot of focus on the solar component for enhanced disinfection. However, the role played by the host immune system following the consumption of solar-irradiated water pathogens has not received any significant attention. The mode of inactivation resulting from the exposure of microbiologically contaminated water results in immunologically important microbial states as well as components. In this review, the possible influence that solar water disinfection may have on the immunity against cholera is discussed.

A novel point-of-use water treatment method by antimicrobial nanosilver textile material

10 December 2014 10:58 (America/New_York)

A novel point-of-use water treatment method by antimicrobial nanosilver textile material. J Water Health. 2014 Dec;12(4):670-7. doi: 10.2166/wh.2014.197.

Liu H1, Tang X2, Liu Q3. Author information: 1Key Laboratory of Natural Medicine and Immuno-Engineering of Henan Province, Henan University, Kaifeng, Henan 475004, China E-mail:; AGplus Technologies Pte Ltd, 10 Jalan Besar #10-06 Sim Lim Tower, Singapore 208787.
2AGplus Technologies Pte Ltd, 10 Jalan Besar #10-06 Sim Lim Tower, Singapore 208787.
3School of Architecture and the Built Environment, Singapore Polytechnic, 500 Dover Road, Singapore 139651.

Pathogenic bacteria are one of the main reasons for worldwide water-borne disease causing a big threat to public health, hence there is an urgent need to develop cost-effective water treatment technologies. Nano-materials in point-of-use systems have recently attracted considerable research and commercial interests as they can overcome the drawbacks of traditional water treatment techniques. We have developed a new point-of-use water disinfection kit with nanosilver textile material. The silver nanoparticles were in-situ generated and immobilized onto cotton textile, followed by fixing to a plastic tube to make a water disinfection kit. By soaking and stirring the kit in water, pathogenic bacteria have been killed within minutes. The silver leaching from the kit was insignificant, with values <100 ppb – the current US EPA and WHO limit for silver level in drinking water. Herein, the nanosilver textile water disinfection kit could be a new, efficient and cost-effective point-of-use water treatment method for rural areas and emergency preparedness.


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