title: Did point-of-use drinking water strategies for children change in the Dominican Republic during a cholera epidemic?
abstract: OBJECTIVE
  Point-of-use (POU) strategies to improve drinking water, particularly chlorination, are promoted within cholera epidemics when centrally delivered safe drinking water is lacking. Most studies examining POU practices during cholera epidemics have relied on single cross-sectional studies which are limited for assessing behavioural changes. This study examined POU practices in a community over time during a cholera outbreak.
  
  
  METHODS
  Secondary data analysis of existing dataset.
  
  
  METHODS
  During attendance at well-baby clinics serving a low-income peri-urban community in the Dominican Republic, mothers had been routinely asked, using a structured questionnaire, about POU strategies used for drinking water for their children. Frequency distribution of reported practices was determined over a 21 month period during the cholera outbreak on the island of Hispaniola.
  
  
  RESULTS
  An estimated 27.8% of children were reported to have had some exposure to untreated tap water. Unsustained reductions in exposure to untreated tap water were noted early in the epidemic. POU chlorination was infrequent and showed no significant or sustained increases over the study time period.
  
  
  CONCLUSIONS
  High reliance on bottled water, consistent with national household patterns prior to the cholera outbreak, may have reduced the perceived need for POU chlorination. Examination of the safety of relying on bottled water during cholera outbreaks is needed. Additionally, further inquiries are needed to understand variation in POU practices both during and beyond cholera outbreaks.
authors.affiliation: Department of Paediatrics, Cumming School of Medicine, University of Calgary, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Psychiatry, Cumming School of Medicine, University of Calgary, Canada. Electronic address: jmclenna@ucalgary.ca.
authors.forename: J D
authors.initials: JD
authors.lastname: McLennan
mesh_terms: D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology*; D004293:Dominican Republic / Q000453:epidemiology; D060766:Drinking Water / Q000737:chemistry / Q000592:standards; D058872:Epidemics / Q000517:prevention & control; D054879:Halogenation; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D012449:Safety; D011795:Surveys and Questionnaires
chemical_list: D060766:Drinking Water
keywords: Child; Chlorine; Cholera; Dominican Republic; Drinking water; Haiti