Abstract
.Approximately two billion people lack access to microbiologically safe drinking water globally. Boiling is the most popular household water treatment method and significantly reduces diarrheal disease, but is often practiced inconsistently or ineffectively. The use of low-cost technologies to improve boiling is one approach with potential for increasing access to safe drinking water. We conducted household trials to evaluate the feasibility and acceptability of water pasteurization indicators (WAPIs) in the Peruvian Amazon in 2015. A total of 28 randomly selected households were enrolled from a rural and a peri-urban community. All households trialed two WAPI designs, each for a 2-week period. Ninety-six percent of participants demonstrated the correct use of the WAPIs at the end of each trial, and 88% expressed satisfaction with both WAPI models. Ease of use, short treatment time, knowledge of the association between WAPI use and improved health, and the taste of treated water were among the key factors that influenced acceptability. Ease of use was the key factor that influenced design preference. Participants in both communities preferred a WAPI with a plastic box that floated on the water’s surface compared with a WAPI with a wire that was dipped into the pot of drinking water while it was heating (77% versus 15%, P < 0.001); we selected the box design for a subsequent randomized trial of this intervention. The high feasibility and acceptability of the WAPIs in this study suggest that these interventions have potential to increase access to safe water in resource-limited settings.
Highlights
An estimated 2.1 billion people lack access to safely managed water,[1] and 502,000 deaths annually are attributed to unsafe or insufficient drinking water in low- and middle-income countries (LMICs).[2]
The findings of this study demonstrate the feasibility and acceptability of two water pasteurization indicators (WAPIs) in rural and peri-urban communities in the Peruvian Amazon
The acceptability of this type of intervention was influenced by a variety of factors including ease of use, the time required to treat, the taste of treated water, knowledge of the relationship between water quality and health, self-efficacy to use the WAPI, literacy, gender roles, and perception of the effect of treatment on drinking water safety
Summary
An estimated 2.1 billion people lack access to safely managed water,[1] and 502,000 deaths annually are attributed to unsafe or insufficient drinking water in low- and middle-income countries (LMICs).[2]. Consistent and effective practice of boiling is, limited by the risk of recontamination,[17,21,22] time,[23] cost of fuel,[24] risk of injury or scalding,[25,26] and its contribution to indoor air pollution.[27]
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