Abstract
Chlorination is a chemical method for water disinfection that has been proved to be highly effective in controlling waterborne diarrheal diseases. Most studies have focused on wells’ chlorination or later at household level, whereas there have been relatively few researches evaluating the treatment of reservoirs water. Our study followed a mixed design with a before-and-after comparison. It was conducted in a refugee settlement, Um-Baddah Nevachah, which is located in the western outskirts of Khartoum, Sudan. Baseline total coliform test findings have paired areas of four wells that were labeled as sample or control based on fair coin-tossing. A centrally administered water treatment that contains chlorine was added to intervention wells, whereas the other set was considered as chlorine-free placebo. Data were collected 15 days later from the following four main sources: total coliform count, questionnaire-based experimental data trackers, health center records, and face-to-face interviews. The calculated sample size was 341 with corresponding controls selected by systematic random sampling. We found that both groups’ prevalences of waterborne diseases were significantly different before the intervention and they shifted later (p = 0.043 vs. p = 0.496, 95% CI). These findings suggest that reservoir chlorination provides prompt disinfection of well-tank-faucet systems water. Highly credible gastroenteritis is a useful tool to detect cases of gastroenteritis in resources limit settings.
Highlights
Drinking water should be safe and wholesome to fulfill four aspects of the World Health Organization’s Guidelines for Drinking-Water Quality (WHO-GDWQ): acceptability, microbiological, chemical, and radiological
In Sudan, drinking water comes from three main sources: rains, ground, and surface water that include harvested runoff such as “Haffers.” Water should be stored, filtered, and disinfected before it is safe to be used by end consumers
Clinical features are best described as Highly Credible Gastroenteritis (HCG) when any single criterion of the following is present in 24-h duration: ≥2 loose stools, ≥2 episodes of vomiting, one loose stool together with abdominal pain or nausea or vomiting, or one episode of vomiting with abdominal pain or nausea [7]
Summary
Drinking water should be safe and wholesome to fulfill four aspects of the World Health Organization’s Guidelines for Drinking-Water Quality (WHO-GDWQ): acceptability, microbiological, chemical, and radiological. In Sudan, drinking water comes from three main sources: rains, ground, and surface water that include harvested runoff such as “Haffers.” Water should be stored, filtered, and disinfected before it is safe to be used by end consumers. Inadequate disinfection results in “diseases acquired by drinking water contaminated at its source or in the distribution system, or by direct contact with environmental and recreational waters [4].”. Clinical features are best described as Highly Credible Gastroenteritis (HCG) when any single criterion of the following is present in 24-h duration: ≥2 loose stools, ≥2 episodes of vomiting, one loose stool together with abdominal pain or nausea or vomiting, or one episode of vomiting with abdominal pain or nausea [7]. Clinical presentations are categorized into three levels: probable cases with nonspecific gastrointestinal symptoms; suspected cases are those that meet the HCG criteria, and confirmed cases are the diagnosed ones
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