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.
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.
Civil and Environmental Engineering, Stanford University, Stanford, CA, United States of America; Woods Institute for the Environment, Stanford University, Stanford, CA, United States of America.
Amy J
AJ
Pickering
Civil and Environmental Engineering, Stanford University, Stanford, CA, United States of America.
Yoshika
Y
Crider
International Center for Diarrheal Diseases Research, Dhaka, Bangladesh.
Nuhu
N
Amin
Civil and Environmental Engineering, Stanford University, Stanford, CA, United States of America.
Valerie
V
Bauza
International Center for Diarrheal Diseases Research, Dhaka, Bangladesh.
Leanne
L
Unicomb
Civil and Environmental Engineering, Stanford University, Stanford, CA, United States of America; Woods Institute for the Environment, Stanford University, Stanford, CA, United States of America.
Jennifer
J
Davis
Woods Institute for the Environment, Stanford University, Stanford, CA, United States of America.
Stephen P
SP
Luby
D000328:Adult; D001459:Bangladesh; D002648:Child; D003967:Diarrhea / Q000191:economics / Q000517:prevention & control*; D060766:Drinking Water / Q000032:analysis*; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D054879:Halogenation; D006801:Humans; D008297:Male; D011203:Poverty; D014876:Water Pollution / Q000032:analysis* / Q000191:economics / Q000706:statistics & numerical data; D018508:Water Purification / Q000295:instrumentation / Q000379:methods*; D060753:Water Quality; D014881:Water Supply / Q000379:methods
D060766:Drinking Water