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Household water treatment is increasingly recognized as an effective means of reducing the burden of diarrheal disease among low-income populations without access to safe water. Oxfam GB undertook a pilot project to explore the use of household-based ceramic water filters in three remote communities in Colombia. In a randomized, controlled trial over a period of six months, the filters were associated with a 75.3% reduction in arithmetic mean thermotolerant coliforms (TTCs) (P < 0.0001). A total of 47.7% and 24.2% of the samples from the intervention group had no detectible TTCs/100 mL or conformed to World Health Organization limits for low risk (1–10 TTCs/100 mL), respectively, compared with 0.9% and 7.3% for control group samples. Overall, prevalence of diarrhea was 60% less among households using filters than among control households (odds ratio = 0.40, 95% confidence interval = 0.25, 0.63, P < 0.0001). However, the microbiologic performance and protective effect of the filters was not uniform throughout the study communities, suggesting the need to consider the circumstances of the particular setting before implementing this intervention.
Received April 1, 2005. Accepted for publication May 23, 2005.
Acknowledgments: We thank Fredy Vidal and Luz Marina Londono (Oxfam GB-Colombia) for conducting the field work in connection with this study, Timothy Forster (Oxfam GB) for providing technical support, and Joseph Brown (University of North Carolina, Chapel Hill, NCV) for supplying the filter schematic. We also thank the study participants in the communities of Curvaradó, Dabeiba, and Cartagenita.
Financial support: Thomas Clasen and Simon Collin are on the staff of the London School of Hygiene and Tropical Medicine, which receives funding for water research from Unilever, Ltd. Gloria Garcia Parra is on the staff of Oxfam (United Kingdom). Thomas Clasen and Sophie Boisson serve as consultants to International Health Research Associates, Ltd., a consulting group whose work includes laboratory and field assessments of water treatment technologies. Apart from their normal compensation, no special funding was provided to the authors to support this research.
Disclaimers: As noted above, the research of Thomas Clasen, Sophie Boisson, and Simon Collin is supported in part by Unilever Ltd. and International Health Research Associates, Ltd. whose activities may include the assessment and promotion of household-based water treatment technologies. However, to the best of the authors’ knowledge, none of these companies manufacture or sell ceramic water filters.
* Address correspondence to Thomas Clasen, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. E-mail: thomas.clasen{at}lshtm.ac.uk
Authors’ addresses: Thomas Clasen and Simon Collin, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, E-mails: thomas.clasen{at}lshtm.ac.uk and simon.collin{at}lshtm.ac.uk. Gloria Garcia Parra, Oxfam GB, 274 Banbury Road, Oxford OX2 7DZ, United Kingdom, E-mail: GGarcia{at}oxfam.org.uk. Sophie Boisson, International Health Research Associates, Ltd., 22 Clyro Court, Tollington Park, London N4 3AQ, United Kingdom, E-mail: s_boisson{at}hotmail.com.
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