Point-of-use (POU) water treatment with sodium hypochlorite (NaOCl) has been proven to reduce diarrheal disease in developing countries. However, program implementation is complicated by unclear free chlorine residual guidelines for POU water treatment and difficulties in determining appropriate dosage recommendations. The author presents evidence supporting proposed criteria for household water treatment for free chlorine residuals of < 2.0 mg/L1 h after NaOCl addition and > 0.2 mg/L aft
Point-of-use water treatment (PoUWT), such as boiling or chlorine disinfection, has long been recommended in emergencies. While there is increasing evidence that these and other PoUWT options improve household water microbiological quality and reduce diarrhoeal disease in the development context, it is unknown whether these results are generalizable to emergencies.
Effectiveness of chlorine dispensers in emergencies: case study results from Haiti, Sierra Leone, Democratic Republic of Congo, and Senegal
Dispensers are a source-based water quality intervention with promising uptake results in development contexts. Dispenser programs include a tank of chlorine with a dosing valve that is installed next to a water source, a local Promoter who conducts community education and refills the Dispenser, and chlorine refills. In collaboration with response organizations, we assessed the effectiveness of Dispensers in four emergency situations.
This evidence synthesis identifies, synthesizes and evaluates existing evidence of the impacts of water, sanitation, and hygiene (WASH) interventions in disease outbreaks in 51 humanitarian contexts in 19 low and middle-income countries. The research team developed theories of change for the WASH interventions under consideration, documenting the theoretical route from intervention activities to outputs, outcomes, and impacts. WASH interventions consistently reduce both the risk of disease and the risk of transmission in outbreak contexts.
Household water treatment uptake during a public health response to a large typhoid fever outbreak in Harare, Zimbabwe
Locally manufactured sodium hypochlorite (chlorine) solution has been sold in Zimbabwe since 2010. During October 1, 2011–April 30, 2012, 4,181 suspected and 52 confirmed cases of typhoid fever were identified in Harare. In response to this outbreak, chlorine tablets were distributed. To evaluate household water treatment uptake, we conducted a survey and water quality testing in 458 randomly selected households in two suburbs most affected by the outbreak.
Efficacy and effectiveness of water, sanitation, and hygiene interventions in emergencies in low- and middle-income countries: a systematic review
There are increasing numbers of people affected by natural disasters, disease outbreaks, and conflict. Water, sanitation, and hygiene (WASH) interventions are used in nearly all emergency responses to help reduce disease risk. However, there is a lack of summarized evidence on the efficacy and effectiveness of these interventions.
Water, sanitation, and hygiene are one part of a cholera control strategy. Household water treatment (HWT) in particular has been shown to improve the microbiological quality of stored water and reduce the disease burden. We conducted a systematic review of published and gray literature to determine the outcomes and impacts of HWT in preventing cholera specifically. Fourteen manuscripts with 18 evaluations of HWT interventions in cholera were identified. Overall, a moderate quality of evidence suggests that HWT int