title: A randomized controlled trial of household-based flocculant-disinfectant drinking water treatment for diarrhea prevention in rural Guatemala.
abstract: We conducted a study to determine if use of a new flocculant-disinfectant home water treatment reduced diarrhea. We randomly assigned 492 rural Guatemalan households to five different water treatment groups: flocculant-disinfectant, flocculant-disinfectant plus a customized vessel, bleach, bleach plus a vessel, and control. During one year of observation, residents of control households had 4.31 episodes of diarrhea per 100 person-weeks, whereas the incidence of diarrhea was 24% lower among residents of households receiving flocculant-disinfectant, 29% lower among those receiving flocculant-disinfectant plus vessel, 25% lower among those receiving bleach, and 12% lower among households receiving bleach plus vessel. In unannounced evaluations of home drinking water, free chlorine was detected in samples from 27% of flocculant-disinfectant households, 35% of flocculant-disinfectant plus vessel households, 35% of bleach households, and 43% of bleach plus vessel households. In a setting where diarrhea was a leading cause of death, intermittent use of home water treatment with flocculant-disinfectant decreased the incidence of diarrhea.
authors.affiliation: Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Reller
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Mendoza
authors.forename: M Beatriz
authors.initials: MB
authors.lastname: Lopez
authors.forename: Maricruz
authors.initials: M
authors.lastname: Alvarez
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hoekstra
authors.forename: Christy A
authors.initials: CA
authors.lastname: Olson
authors.forename: Kathleen G
authors.initials: KG
authors.lastname: Baier
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Keswick
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
mesh_terms: D002675:Child, Preschool; D017606:Chlorine Compounds; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D004202:Disinfectants; D005260:Female; D005427:Flocculation; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012423:Rural Health; D012621:Seasons; D014871:Water Microbiology; D014881:Water Supply
chemical_list: D017606:Chlorine Compounds; D004202:Disinfectants