Effectiveness of Membrane Filtration to Improve Drinking Water: A Quasi-Experimental Study from Rural Southern India.
Since point-of-use methods of water filtration have shown limited acceptance in Vellore, southern India, this study evaluated the effectiveness of decentralized membrane filtration 1) with safe storage, 2) without safe storage, versus 3) no intervention, consisting of central chlorination as per government guidelines, in improving the microbiological quality of drinking water and preventing childhood diarrhea. Periodic testing of water sources, pre-/postfiltration samples, and household water, and a biweekly follow up of children less than 2 years of age was done for 1 year. The membrane filters achieved a log reduction of 0.86 (0.69-1.06), 1.14 (0.99-1.30), and 0.79 (0.67-0.94) for total coliforms, fecal coliforms, and Escherichia coli, respectively, in field conditions. A 24% (incidence rate ratio, IRR [95% confidence interval, CI] = 0.76 [0.51-1.13]; P = 0.178) reduction in diarrheal incidence in the intervention village with safe storage and a 14% (IRR [95% CI] = 1.14 [0.75-1.77]; P = 0.530) increase in incidence for the intervention village without safe storage versus no intervention village was observed, although not statistically significant. Microbiologically, the membrane filters decreased fecal contamination; however, provision of decentralized membrane-filtered water with or without safe storage was not protective against childhood diarrhea.
Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Mark Rohit
MR
Francis
Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Rajiv
R
Sarkar
Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Sheela
S
Roy
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Shabbar
S
Jaffar
Department of Community Health, Christian Medical College, Vellore, India.
Venkata Raghava
VR
Mohan
Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Gagandeep
G
Kang
Society for Applied Studies, Vellore, India.
Vinohar
V
Balraj
D002675:Child, Preschool; D003967:Diarrhea / Q000517:prevention & control; D060766:Drinking Water / Q000382:microbiology* / Q000592:standards; D004755:Enterobacteriaceae / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005191:Family Characteristics; D005243:Feces / Q000821:virology; D005260:Female; D005374:Filtration / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D065228:Non-Randomized Controlled Trials as Topic; D012424:Rural Population; D014871:Water Microbiology; D018508:Water Purification / Q000379:methods*; D060753:Water Quality / Q000592:standards
D060766:Drinking Water