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Abstract
Diarrheal disease and environmental enteropathy are serious public health concerns in low-income countries. In an effort to reduce enteric infection, researchers at the University of Virginia developed a new point-of-use (POU) water treatment technology composed of silver-impregnated porous ceramic media. The ceramic is placed in a 15 L plastic container of water in the evening and the water is ready to drink in the morning. The purpose of this study was to assess field performance and local acceptance of technology in two communities in Limpopo Province, South Africa, and one community in Dodoma Region, Tanzania. Performance was determined by coliform testing of treated water. Acceptance was determined using data from 150 household surveys and a nine-day structured observational study at a local primary school. At the primary school, 100% of treated water samples had no detectable levels of total coliform bacteria (TCB) in buckets filled by researchers. For all treated school buckets, 74% of samples achieved less than or equal to 1 CFU/100 mL and 3.2 average log reduction of TCB. Laboratory experiments with highly contaminated water diluted to lower turbidity achieved 4.2 average log reduction of TCB. Turbid water (approximately 10 NTU) only achieved 1.1 average log reduction of TCB; turbidity and organic material may have interfered with disinfection. The Tanzania primary school (deep groundwater source) had less turbid water and achieved 1.4 average log reduction of TCB; however, it did have high chloride levels that may have interfered with silver disinfection. The surveys revealed that the majority of people retrieve, store, and dispense water in ways that are compatible with the new technology. The willingness-to-pay study revealed potential customers would be willing to pay for the technology without subsidies. The results of this study indicate that this novel silver-impregnated ceramic POU water treatment technology is both effective and appropriate for use in the study communities.
Highlights
Worldwide, diarrheal disease is a leading cause of mortality [1] and accounts for 15% of all deaths among children under the age of 5
Trials in the primary school in community A showed a significant reduction of bacteria in the drinking3.1
100% achieved no detection ofschool total coliform bacteria and aofsignificant all buckets measured at theinschool and Trials in the primary in community
Summary
Diarrheal disease is a leading cause of mortality [1] and accounts for 15% of all deaths among children under the age of 5. The prevalence of early childhood enteric infection has been correlated with subsequent diminished school performance as well as impaired cognitive and physical function [1,3]. Such stunting has been termed environmental enteropathy [4]. Studies suggest that chronic exposure to fecal pathogens leads to intestinal inflammation and blunting of the intestinal villi. Long-term inflammation can cause permanent structural changes in the intestinal wall, contributing to malnutrition, poor nutrient absorption, and impaired immune response [5]. Coli and Cryptosporidium infections, even without diarrheal symptoms, predispose children to growth stunting [6]
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