title: Point-of-use water treatment and diarrhoea reduction in the emergency context: an effectiveness trial in Liberia.
abstract: Communicable diseases are of particular concern in conflict and disaster-affected populations that reside in camp settings. In the acute emergency phase, diarrhoeal diseases have accounted for more than 40% of deaths among camp residents. Clear limitations exist in current water treatment technologies, and few products are capable of treating turbid water. We describe the findings of a 12-week effectiveness study of point-of-use water treatment with a flocculant-disinfectant among 400 households in camps for displaced populations in Monrovia, Liberia. In intervention households, point-of-use water treatment with the flocculant-disinfectant plus improved storage reduced diarrhoea incidence by 90% and prevalence by 83%, when compared with control households with improved water storage alone. Among the intervention group, residual chlorine levels met or exceeded Sphere standards in 85% (95% CI: 83.1-86.8) of observations with a 95% compliance rate.
authors.affiliation: Johns Hopkins University Center for Refugee and Disaster Response, Baltimore, MD 21205, USA. sdoocy@jhsph.edu
authors.forename: Shannon
authors.initials: S
authors.lastname: Doocy
authors.forename: Gilbert
authors.initials: G
authors.lastname: Burnham
mesh_terms: D002675:Child, Preschool; D002713:Chlorine / Q000032:analysis; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control*; D004202:Disinfectants; D004203:Disinfection / Q000379:methods; D005260:Female; D005427:Flocculation; D006794:Household Articles; D006801:Humans; D015994:Incidence; D007988:Liberia / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D014857:Warfare; D014867:Water / Q000032:analysis; D014871:Water Microbiology; D014876:Water Pollution; D018508:Water Purification / Q000379:methods*; D014881:Water Supply / Q000592:standards*
chemical_list: D004202:Disinfectants; D014867:Water; D002713:Chlorine