Diarrhea Safe water treatment and storage in the home: A practical new strategy to prevent waterborne disease Mintz

E, Reiff F, Tauxe R
In many parts of the developing world, drinking water is collected from unsafe surface sources outside the home and is then held in household storage vessels. Drinking water may be contaminated at the source or during storage; strategies to reduce waterborne disease transmission must safeguard against both events. We describe a two-component prevention strategy, which allows an individual to disinfect drinking water immediately after collection (point-of-use disinfection) and then to store the water in narrow-mouthed, closed vessels designed to prevent recontamination (safe storage). New disinfectant generators and better storage vessel designs make this strategy practical and inexpensive. This approach empowers households and communities that lack potable water to protect themselves against a variety of waterborne pathogens and has the potential to decrease the incidence of waterborne diarrheal disease. DIARRHEAL diseases remain a leading cause of illness and death in the developing world Providing potable water for drinking and washing is critical to reducing, diarrheal disease transmission in this setting . However, improving source water quality alone does not always decrease diarrheal disease incidence Providing a safe drinking water source may fail to reduce diarrhea because transmission of diarrheal pathogens continues through foodborne or person-to-person routes of spread or because people are exposed to contaminated water during bathing and other activities. Drinking water also becomes contaminated after collection, either during transport or storage in the home. Improvements in source water quality generally depend on expensive, long-term, centralized projects, such as construction of wells, water treatment plants, and water distribution systems. During the World Health Organization's (WHO's) Drinking Water Supply and Sanitation decade (1981 to 1990), an effort was made to increase access to potable water in developing countries but was nearly outstripped by population expansion and migration from rural to urban areas. Safe drinking water for all remains an elusive and expensive goal. In 1990, more than 1 billion people depended on rivers, streams, or other unsafe surface sources for drinking water. In many developing countries, even municipal piped well water is unsafe, because of inadequately maintained pipes, low pressure, intermittent delivery, lack of chlorination, and clandestine connections. For example, Vibrio cholerae was repeatedly isolated from unchlorinated municipal water systems in Peru that caused large epidemics of cholera. In Guayaquil, Ecuador, even central chlorination of the municipal water system was insufficient to maintain adequate free chlorine residuals at peripheral distribution sites, and drinking unboiled municipal water remained a primary source of cholera. An inexpensive strategy is available to improve household drinking water until piped potable water is routinely available. The strategy has two components: water disinfection at the time water is collected (point-of-use disinfection) and water storage in vessels specifically designed to prevent recontamination (safe storage). However, successful implementation of this strategy will require focused educational campaigns stressing the role of contaminated water and domestic hygiene in disease transmission. Sebelum menyediakan air bersih untuk kemudian dikonsumsi sebagai air minum sebaiknya individu tersebut harus mencuci tangan dengan benar untuk mengurangi penularan penyakit diare. Di negara berkembang mengonsumsi air sumur atau air yang sudah direbus sebelumnya sudah tidak aman disebabkan karena kurangnya tekanan, kurangnya klorinasi

menyebabkan tersebarnya epidemi kolera. Strategi ini akan membahas 2 cara pencegahan penyebaran epidemi penyakit melalui air minum yaitu dengan melakukan desinfeksi pada instalasi air minum dan melakukan penyimpanan pada tempat khusus yang aman untuk mencegah adanya kontaminasi ulang

Providing clean water, keeping water clean: an integrated approach

Authors: Thompson; Sobsey; Bartram DOI: 10.1080/0960312031000102840 Publication Frequency: 6 issues per year Published in: International Journal of Environmental Health Research, Volume 13, Issue 1 Supplement 1 January 2003 , pages S89 - S94 Subjects: Environmental Health; Epidemiology; Microbiology; Number of References: 1 Formats available: PDF (English) Article Requests: Order Reprints : Request Permissions Abstract Millions of people, most of whom are children in developing countries, die of basic hygienerelated diseases every year. Interventions in hygiene, sanitation and water supply have been shown to control disease burden. Universal access to improved water sources and basic sanitation remains elusive but is an important long-term goal. Studies have shown that improving the microbiological quality of household water by on-site or point-of-use treatment and safe storage in improved vessels reduces diarrhoeal and other waterborne diseases in communities and households of developing and developed countries. The extent to which improving drinking water quality at the household level reduces diarrhoeal disease probably depends on a variety of technology-related and site-specific environmental and demographic factors that require further investigation, characterisation and analyses. Keywords: Hygiene-related Disease; Sanitation; Low-cost Intervention; Water Storage System; Affordability; Safe Water; Uv Disinfection; Chemical Disinfectants; CoagulationFlocculation; Sedimentation; Filtration; Chlorination; Multi-barrier Approach; Socio-cultural Acceptability Sejauh mana meningkatkan kualitas air minum di tingkat rumah tangga mengurangi penyakit diare mungkin tergantung pada berbagai faktor lingkungan dan teknologi yang terkait demografi dan spesifik lokasi yang memerlukan penyelidikan lebih lanjut, karakterisasi dan analisis.

UJI BAKTERIOLOGI AIR BAKU DAN AIR SIAP KONSUMSI DARI PDAM SURAKARTA DITINJAU DARI JUMLAH BAKTERI Coliform
PRAYITNO, AGUS (2009) UJI BAKTERIOLOGI AIR BAKU DAN AIR SIAP KONSUMSI DARI PDAM SURAKARTA DITINJAU DARI JUMLAH BAKTERI Coliform. Skripsi thesis, Universitas Muhammadiyah Surakarta. Image view: http://viewer.eprints.ums.ac.id/archive/etd/3821

Abstract
Air baku adalah air bersih yang dipakai untuk kebutuhan air minum, air rumah tangga dan industri. Air siap konsumsi (potable water) adalah air yang aman (sehat) dan bagus untuk dikonsumsi, tidak berwarna, tidak berbau, serta rasanya segar. Air yang aman dan sehat adalah air yang tidak mengandung mikroorganisme dan partikel-partikel berbahaya bagi kesehatan tubuh. Tujuan penelitian ini adalah untuk mengetahui kualitas air baku dan air siap konsumsi dari PDAM Surakarta berdasarkan jumlah Coliform. Penelitian ini dilaksanakan menggunakan metode eksperimen dan untuk menghitung jumlah Coliform menggunakan uji The Most Probable Number (MPN) yang meliputi uji pendugaan dan uji penegasan. Analisis data yang digunakan adalah deskriptif kualitatif. Penentuan kualitas air yang diuji berdasarkan keputusan Permenkes RI No.907/Menkes/SK/VII/2002 Hasil penelitian menunjukkan bahwa pada sampel 1 diperoleh indeks MPN 3:2:0 dan 1:0:0 pada uji penduga dan uji penegasan menunjukkan jumlah bakteri Coliform 93 sel dan 4 sel per 100 ml. Sampel 2 diperoleh indeks MPN 2:0:0 dan 1:0:0 pada pengujian pendugaan dan uji penegasan menunjukkan jumlah bakteri Coliform 9 sel dan 4 sel per 100 ml. Dapat disimpulkan bahwa sampel 1 dan 2 tidak layak untuk dikonsumsi berdasarkan uji bakteriologi menggunakan standart The Most Probable Number (MPN) dengan jumlah bakteri Coliform di atas 0 sel per 100 ml sampel.
Item Type: ID Number: Karya Ilmiah (Skripsi) A420040040

Additional Information: RAK A420-049 Uncontrolled Keywords: Air Baku, Air Siap Konsumsi, Uji Bakteriologi, MPN, Coliform. Subjects: Divisions: ID Code: Deposited By: Deposited On: Last Modified: S Agriculture > SH Aquaculture. Fisheries. Angling Q Science > QH Natural history > QH301 Biology Fakultas Keguruan dan Ilmu Pendidikan > Pendidikan Biologi 3821 Mbak Esti Handayani 29 Jul 2009 14:33 22 Oct 2009 13:43

Water distribution system and diarrheal disease transmission: a case study in Uzbekistan
JC Semenza, L Roberts, A Henderson, J Bogan, and CH Rubin Deteriorating water treatment facilities and distribution systems pose a significant public health threat, particularly in republics of the former Soviet Union. Interventions to decrease the disease burden associated with these water systems range from upgrading distribution networks to installing reverse osmosis technology. To provide insight into this decision process, we conducted a randomized intervention study to provide epidemiologic data for water policy decisions in Nukus, Uzbekistan, where drinking water quality is suboptimal. We interviewed residents of 240 households, 120 with and 120 without access to municipal piped water. Residents of 62 households without piped water were trained to chlorinate their drinking water at home in a narrow-necked water container with a spout. All study subjects (1583 individuals) were monitored biweekly for self-reported diarrheal illness over a period of 9.5 weeks. The home chlorination intervention group had the lowest diarrheal rate (28.8/1,000 subjects/month) despite lack of access to piped water in their homes. Compared with the two groups that did not receive the intervention this rate was one-sixth that of the group with no piped water (179.2/1,000 subjects/month) and one-third that of the households with piped water (75.5/1,000 subjects/month). More than 30% of the households with piped water lacked detectable levels of chlorine residues in their drinking water, despite two-stage chlorination of the source water, and were at increased risk of diarrhea. Forty-two percent of these municipal users reported that water pressure had been intermittent within the previous two days. The dramatic reduction in diarrheal rates in the home-chlorination intervention group indicates that a large proportion of diarrheal diseases in Nukus are water-borne. The home-chlorination group had less diarrhea than the group with piped water, implicating the distribution system as a source of disease transmission. Taken together, these epidemiologic data would support the hypothesis that diarrhea in the piped water group could be attributed to cross-contamination between the municipal water supply and sewer, due to leaky pipes and lack of water pressure. Relatively inexpensive steps, including chlorination, maintaining water pressure, and properly maintaining the distribution system, rather than reverse osmosis technology, should reduce diarrheal rates. Memburuknya fasilitas pengolahan air dan sistem distribusi menjadi ancaman kesehatan publik yang signifikan, terutama di republik bekas Uni Soviet. Intervensi untuk mengurangi beban penyakit yang terkait dengan sistem air berkisar dari upgrade jaringan distribusi untuk menginstal teknologi reverse osmosis. Penurunan dramatis di tingkat diare pada kelompok intervensi rumah-klorinasi menunjukkan bahwa sebagian besar penyebab penyakit diare di Nukus adalah karena air. Secara keseluruhan, data-data epidemiologi mendukung hipotesis penyebaran penyakit diare bahwa pipa air yang ada dapat tercemar karena disebabkan kontaminasi silang antara pasokan air kota dan got, karena pipa bocor dan kurangnya tekanan air. Langkah-langkah yang relatif murah, termasuk klorinasi, mempertahankan tekanan air, mempertahankan sistem distribusi, daripada teknologi reverse osmosis, harus mengurangi tingkat diare.

Combining drinking water treatment and hand washing for diarrhoea prevention, a cluster randomised controlled trial
SP Luby, M Agboatwalla, J Painter, A - Tropical Medicine , 2006 - interscience.wiley.com

Stephen P. Luby 1 , Mubina Agboatwalla 2 , John Painter 1 , Arshad Altaf 3 , Ward Billhimer 4 , Bruce Keswick 4 and Robert M. Hoekstra Objectives To evaluate the effectiveness of point of use water treatment with flocculentdisinfectant on reducing diarrhoea and the additional benefit of promoting hand washing with soap. Methods The study was conducted in squatter settlements of Karachi, Pakistan, where diarrhoea is a leading cause of childhood death. Interventions were randomly assigned to 47 neighbourhoods. Households in 10 neighbourhoods received diluted bleach and a water vessel; nine neighbourhoods received soap and were encouraged to wash hands; nine neighbourhoods received flocculent-disinfectant water treatment and a water vessel; 10 neighbourhoods received disinfectant-disinfectant water treatment and soap and were encouraged to wash hands; and nine neighbourhoods were followed as controls. Field workers visited households at least once a week from April to December 2003 to promote use of the interventions and to collect data on diarrhoea. Results Study participants in control neighbourhoods had diarrhoea on 5.2% of days. Compared to controls, participants living in intervention neighbourhoods had a lower prevalence of diarrhoea: 55% (95% CI 17%, 80%) lower in bleach and water vessel neighbourhoods, 51% (95% CI 12%, 76%) lower in hand washing promotion with soap neighbourhoods, 64% lower (95% CI 29%, 90%) in disinfectant-disinfectant neighbourhoods, and 55% (95% CI 18%, 80%) lower in disinfectant-disinfectant plus hand washing with soap neighbourhoods. Conclusions With an intense community-based intervention and supplies provided free of cost, each of the home-based interventions significantly reduced diarrhoea. There was no benefit by combining hand washing promotion with water treatment. Tujuan Untuk mengevaluasi efektivitas pengobatan titik penggunaan air dengan flocculentdisinfektan dalam mengurangi diare dan manfaat tambahan untuk mempromosikan mencuci tangan dengan sabun. Metode Penelitian dilakukan di permukiman liar Karachi, Pakistan, dimana diare adalah penyebab utama kematian anak-anak. Intervensi secara acak diberikan 47 lingkungan. Rumah Tangga di 10 RW menerima diencerkan pemutih dan kapal air; sembilan RW menerima sabun dan didorong untuk mencuci tangan; sembilan lingkungan menerima pengobatan air flocculent-disinfektan dan kapal air; 10 RW menerima pengobatan disinfektan-air sabun dan desinfektan dan didorong untuk mencuci tangan, dan sembilan lingkungan diikuti sebagai kontrol. pekerja Lapangan mengunjungi rumah tangga paling tidak sekali seminggu dari bulan April sampai Desember 2003 untuk mempromosikan penggunaan intervensi dan untuk mengumpulkan data tentang diare. Hasil studi peserta di lingkungan kontrol mempunyai diare pada 5,2% dari hari. Dibandingkan dengan kontrol, peserta tinggal di lingkungan intervensi memiliki prevalensi lebih rendah dari diare: 55% (95% CI 17%, 80%) lebih rendah dengan pemutih dan lingkungan air kapal, 51% (95% CI 12%, 76%) lebih rendah dalam promosi mencuci tangan

dengan sabun lingkungan, 64% lebih rendah (95% CI 29%, 90%) di lingkungan disinfektandisinfektan, dan 55% (95% CI 18%, 80%) lebih rendah di tangan ditambah desinfektandisinfektan sabun cuci dengan lingkungan . Kesimpulan Dengan intervensi berbasis masyarakat intens dan pasokan yang disediakan bebas biaya, masing-masing intervensi berbasis rumah berkurang diare. Tidak ada keuntungan dengan menggabungkan promosi cuci tangan dengan air.

A RANDOMIZED CONTROLLED TRIAL OF HOUSEHOLD-BASED FLOCCULANT-DISINFECTANT DRINKING WATER TREATMENT FOR DIARRHEA PREVENTION IN RURAL GUATEMALA
MEGAN E. RELLER, CARLOS E. MENDOZA, M. BEATRIZ LOPEZ, MARICRUZ ALVAREZ, ROBERT M. HOEKSTRA, CHRISTY A. OLSON, KATHLEEN G. BAIER, BRUCE H. KESWICK, AND STEPHEN P. LUBY
Am. J. Trop. Med. Hyg., 69(4), 2003, pp. Copyright 2003 by The American Society of Tropical Medicine and Hygiene E-mail: sluby@cdc.gov Received May 16, 2003. Accepted for publication July 5, 2003. . 411-419

We conducted a study to determine if use of a new flocculant-disinfectant home water treatment reduced diarrhea. We randomly assigned 492 rural Guatemalan households to five different water treatment groups: flocculant-disinfectant, flocculant-disinfectant plus a customized vessel, bleach, bleach plus a vessel, and control. During one year of observation, residents of control households had 4.31 episodes of diarrhea per 100 person-weeks, whereas the incidence of diarrhea was 24% lower among residents of households receiving flocculantdisinfectant, 29% lower among those receiving flocculant-disinfectant plus vessel, 25% lower among those receiving bleach, and 12% lower among households receiving bleach plus vessel. In unannounced evaluations of home drinking water, free chlorine was detected in samples from 27% of flocculant-disinfectant households, 35% of flocculant-disinfectant plus vessel households, 35% of bleach households, and 43% of bleach plus vessel households. In a setting where diarrhea was a leading cause of death, intermittent use of home water treatment with flocculant-disinfectant decreased the incidence of diarrhea. Kami melakukan studi untuk menentukan apakah penggunaan pengolahan flocculantdisinfektan terhadap air mengurangi resiko diare. Kami secara acak melakukan penelitian pada 492 rumah tangga di pedesaan Guatemala. Dalam pengaturan hasil samplingnya, diare adalah penyebab utama kematian dan pengolahan air sederhana di rumah dengan flocculantdisinfektan menurunkan kejadian diare.

Uses of Ozone in Drinking Water Treatment

Authors: Rice, Rip G.; Robson, C. Michael; Miller, G. Wade; Hill, Archibald G. Citation: Journal AWWA, Vol. 73 Iss. 1, January 1981, Page Range 44-57, 14 Pages custsvc@awwa.org Abstract: Ozone has been used for the treatment of drinking water since 1906 when it was installed in the city of Nice, France, for disinfection purposes. Although many water treatment plants throughout the world still use ozone primarily for disinfection most modern plants rely on ozone to perform one or more oxidation functions. Applications for ozonation now include oxidation of inorganic and organic materials, flocculation and microflocculation for removal of turbidity or suspended solids, and promotion of aerobic biological processes conducted in filter and adsorption media. Bacterial disinfection, viral inactivation, oxidation of soluble iron and manganese, color removal, taste and odor removal, algae control, cyanides, sulfides, nitrites, trihalomethanes, costs, and health effects are discussed. Ozon telah digunakan untuk pengobatan air minum sejak tahun 1906 ketika dipasang di kota Nice, Perancis, untuk tujuan desinfeksi. Meskipun banyak instalasi pengolahan air di seluruh dunia masih menggunakan ozon terutama untuk desinfeksi tanaman paling modern mengandalkan ozon untuk melakukan fungsi satu atau lebih oksidasi. Aplikasi untuk ozonation sekarang termasuk oksidasi bahan anorganik dan organik, flokulasi dan microflocculation untuk menghilangkan kekeruhan atau padatan tersuspensi, dan promosi dari proses biologi aerobik dilakukan di filter dan media adsorpsi. desinfeksi bakteri, virus yang tidak aktif, oksidasi besi dan mangan terlarut, penyisihan warna, rasa dan penghapusan bau, kontrol ganggang, sianida, sulfida, nitrit, trihalomethanes, biaya, dan efek kesehatan yang dibahas.