title: Sodium dichloroisocyanurate tablets for routine treatment of household drinking water in periurban Ghana: a randomized controlled trial.
abstract: We conducted a randomized, placebo-controlled, triple-blinded trial to determine the health impact of daily use of sodium dichloroisocyanurate (NaDCC) tablets for household drinking water treatment in periurban Ghana. We randomized 240 households (3,240 individuals) to receive either NaDCC or placebo tablets. All households received a 20-liter safe water storage vvessel. Over 12 weeks, 446 diarrhea episodes (2.2%) occurred in intervention and 404 (2.0%) in control households (P = 0.38). Residual free chlorine levels indicated appropriate tablet use. Escherichia coli was found in stored water at baseline in 96% of intervention and 88% of control households and at final evaluation in 8% of intervention and 54% of control households (P = 0.002). NaDCC use did not prevent diarrhea but improved water quality. Diarrhea rates were low and water quality improved in both groups. Safe water storage vessels may have been protective. A follow-up health impact study of NaDCC tablets is warranted.
authors.affiliation: Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. bwc8@cdc.gov
authors.forename: Seema
authors.initials: S
authors.lastname: Jain
authors.forename: Osman K
authors.initials: OK
authors.lastname: Sahanoon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Blanton
authors.forename: Ann
authors.initials: A
authors.lastname: Schmitz
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Wannemuehler
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hoekstra
authors.forename: Robert E
authors.initials: RE
authors.lastname: Quick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control; D004202:Disinfectants / Q000737:chemistry*; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011159:Population Surveillance; D018881:Suburban Health; D013607:Tablets; D014227:Triazines / Q000737:chemistry*; D014871:Water Microbiology; D014881:Water Supply; D055815:Young Adult
chemical_list: D004202:Disinfectants; D010919:Placebos; D013607:Tablets; D014227:Triazines; C011765:troclosene