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Household water treatment in poor populations: is there enough evidence for scaling up now?

Environ Sci Technol, 2009; 43(4):986-92
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pub_id
19320147
pubmedid
19320147
ISI
263298600007
reference_type
author
Schmidt, W.P.; Cairncross, S.;
title
Household water treatment in poor populations: is there enough evidence for scaling up now?
secondary_title
Environ Sci Technol
ISBNISSN
0013-936X
volume
43
number
4
pages
986-92
year
2009
abstract
Point-of-use water treatment (household water treatment, HWT) has been advocated as a means to substantially decrease the global burden of diarrhea and to contribute to the Millennium Development Goals. To determine whether HWT should be scaled up now, we reviewed the evidence on acceptability, scalability, adverse effects, and nonhealth benefits as the main criteria to establish how much evidence is needed before scaling up. These aspects are contrasted with the evidence on the effect of HWT on diarrhea. We found that the acceptability and scalability of HWT is still unclear, and that there are substantial barriers making it difficult to identify populations that would benefit most from a potential effect. The nonhealth benefits of HWT are negligible. Health outcome trials suggest that HWT may reduce diarrhea by 30-40%. The problem of bias is discussed. There is evidence that the estimates may be strongly biased. Current evidence does not exclude that the observed diarrhea reductions are largely or entirely due to bias. We conclude that widespread promotion of HWT is premature given the available evidence. Further acceptability studies and large blinded trials or trials with an objective health outcome are needed before HWT can be recommended to policy makers and implementers.
keywords
secondary_author
place_published
publisher
number_of_volumes
tertiary_author
tertiary_title
edition
date
type_of_work
subsidiary_author
alternate_title
call_number
accession_number
custom_1
WOS NEW
custom_2
Unknown
custom_3
custom_4
10.1021/es802232w
custom_5
custom_6
10
label
2016-10-18
notes
Journal Article
url
author_address
Environmental Health Group, London School of Hygiene and Tropical Medicine. Wolf-Peter.Schmidt@lshtm.ac.uk
library
19320147
date_accepted
date_online
created
2009-03-30 09:36:02
modified
2016-07-08 00:00:00
library
<ArticleId IdType="pubmed">19320147</ArticleId>