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1.  Drinking Water Quality, Feeding Practices, and Diarrhea among Children under 2 Years of HIV-Positive Mothers in Peri-Urban Zambia 
In low-income settings, human immunodeficiency virus (HIV)-positive mothers must choose between breastfeeding their infants and risking transmission of HIV or replacement feeding their infants and risking diarrheal disease from contaminated water. We conducted a cross-sectional study of children < 2 years of age of 254 HIV-positive mothers in peri-urban Zambia to assess their exposure to waterborne fecal contamination. Fecal indicators were found in 70% of household drinking water samples. In a multivariable analysis, factors associated with diarrhea prevalence in children < 2 years were mother having diarrhea (adjusted odds ratio [aOR] = 5.18, 95% confidence interval [CI] = 1.65–16.28), child given water in the past 2 days (aOR = 4.08, 95% CI = 1.07–15.52), child never being breastfed (aOR = 2.67, 95% CI = 1.06–6.72), and rainy (versus dry) season (aOR = 4.60, 95% CI = 1.29–16.42). Children born to HIV-positive mothers were exposed to contaminated water through direct intake of drinking water, indicating the need for interventions to ensure microbiological water quality.
doi:10.4269/ajtmh.2011.11-0140
PMCID: PMC3144832  PMID: 21813854
2.  Assessing the Impact of a School-based Safe Water Intervention on Household Adoption of Point-of-Use Water Treatment Practices in Southern India 
We assessed a pilot project by UNICEF and Hindustan Unilever Limited to improve the quality of drinking water for children in schools through adoption of improved drinking water practices among households in southern India. The intervention consisted of providing classrooms of 200 schools a commercial water purifier, and providing basic hygiene and water treatment information to students, parents, and teachers. We found no evidence that the intervention was effective in improving awareness or uptake of effective water treatment practices at home. A similar proportion of household members in the intervention and control groups boiled their water (P = 0.60), used a ceramic filtration system (P = 0.33), and used a cloth filter (P = 0.89). One year after the launch of the campaign, household ownership of the commercial purifier promoted at schools was higher in the intervention group (26%) than the control group (19%), but this difference was not statistically significant (P = 0.53).
doi:10.4269/ajtmh.2011.10-0361
PMCID: PMC3042810  PMID: 21363972
3.  In Response 
doi:10.4269/ajtmh.2012.11-0730b
PMCID: PMC3284381
4.  Microbiological Effectiveness of Disinfecting Water by Boiling in Rural Guatemala 
Boiling is the most common means of treating water in the home and the benchmark against which alternative point-of-use water treatment options must be compared. In a 5-week study in rural Guatemala among 45 households who claimed they always or almost always boiled their drinking water, boiling was associated with a 86.2% reduction in geometric mean thermotolerant coliforms (TTC) (N = 206, P < 0.0001). Despite consistent levels of fecal contamination in source water, 71.2% of stored water samples from self-reported boilers met the World Health Organization guidelines for safe drinking water (0 TTC/100 mL), and 10.7% fell within the commonly accepted low-risk category of (1–10 TTC/100 mL). As actually practiced in the study community, boiling significantly improved the microbiological quality of drinking water, though boiled and stored drinking water is not always free of fecal contaminations.
doi:10.4269/ajtmh.2010.09-0320
PMCID: PMC2829912  PMID: 20207876
5.  Estimating the Scope of Household Water Treatment in Low- and Medium-Income Countries 
For populations without reliable access to safe drinking water, household water treatment (HWT) provides a means of improving water quality and preventing disease. We extracted data on reported HWT practices from 67 national surveys and reports on the scope of HWT. An estimated 33.0% of the households (1.1 billion people) in these countries report treating their drinking water at home. The practice is widespread in the Western Pacific (66.8%) and Southeast Asia (45.4%) regions, and it is less common in the Eastern Mediterranean (13.6%) and Africa (18.2%). Boiling is the most dominant method with 21.0% of the study households (598 million people) using the method. Despite being at higher risk of waterborne disease because of lower coverage of improved water sources, African and rural households are less likely to practice HWT or use microbiologically adequate methods. Validation of the household surveys and further analysis of these data could help optimize HWT practices.
doi:10.4269/ajtmh.2010.09-0382
PMCID: PMC2813171  PMID: 20134007

Results 1-5 (5)