Randomized Intervention Study of Solar Disinfection of Drinking Water in the Prevention of Dysentery in Kenyan Children Aged under 5 Years
Randomized Intervention Study of Solar Disinfection of Drinking Water in the Prevention of Dysentery in Kenyan Children Aged under 5 Years
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DOI：
10.1021/es2018835
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发表时间：
2011-11-01
影响因子：
11.4
通讯作者：
McGuigan, Kevin G.
中科院分区：
文献类型：
--
作者：
du Preez, Martella;Conroy, Ronan M.;McGuigan, Kevin G.
我们报道了一项随机对照干预研究的结果(2007年9月至2009年3月)，调查了饮用水的太阳能消毒(SODIS)对肯尼亚纳库鲁城乡社区6个月至5岁儿童的痢疾、非痢疾腹泻发病率以及身高和体重的人体测量的影响。我们比较了使用SODIS的404个家庭的555名儿童和没有干预的361个家庭的534名儿童。痢疾是用图画日记记录的。经日光消毒后，痢疾和非痢疾腹泻日数和发病例数的发病率比均显著降低(P<0.001)：痢疾天数IRR=0.56(95%CI 0.40~0.79)；痢疾发病IRR=0.55(95%CI 0.42~0.73)；非痢疾发病IRR=0.70(95%CI 0.59~0.84)；体重和身高的人体测量显示，SODIS患者的身高中位数显著增加，相当于1年内整体平均增加0.8厘米(95%可信区间为0.7%至1.6cm，P=0.031)。SODIS的年龄体重中位数较高，相当于同期体重相差0.23公斤；然而，可信区间为零，其效果没有统计学意义(95%CI-0.02至0.47公斤，P=0.068)。在随访期间，SODIS和对照家庭未经处理的家庭水的微生物质量没有差异(P=0.119)，但在所有随访期间，SODIS瓶子中的大肠杆菌浓度显著低于储存容器中的大肠杆菌浓度(P<；0.001)。与对照组的儿童相比，这是第一次显示SODIS对儿童人体测量影响的证据，应该会缓解一些评论员所表示的担忧，即与SODIS相关的较低痢疾率是有偏见的报告的产物，而不是反映发病率真正下降的结果。
We report the results of a randomized controlled intervention study (September 2007 to March 2009) investigating the effect of solar disinfection (SODIS) of drinking water on the incidence of dysentery, nondysentery diarrhea, and anthropometric measurements of height and weight among children of age 6 months to 5 years living in pen-urban and rural communities in Nakuru, Kenya. We compared 555 children in 404 households using SODIS with 534 children in 361 households with no intervention. Dysentery was recorded using a pictorial diary. Incidence rate ratios (IRR) for both number of days and episodes of dysentery and nondysentery diarrhea were significantly (P < 0.001) reduced by use of solar disinfection: dysentery days IRR = 0.56 (95% CI 0.40 to 0.79); dysentery episodes IRR = 0.55 (95% CI 0.42 to 0.73); nondysentery days IRR = 0.70 (95% CI 0.59 to 0.84); nondysentery episodes IRR = 0.73 (95% CI 0.63 to 0.84). Anthropometry measurements of weight and height showed median height-for-age was significantly increased in those on SODIS, corresponding to an average of 0.8 cm over a 1-year period over the group as a whole (95% CI 0.7 to 1.6 cm, P = 0.031). Median weight-for-age was higher in those on SODIS, corresponding to a 0.23 kg difference in weight over the same period; however, the confidence interval spanned zero and the effect fell short of statistical significance (95% CI -0.02 to 0.47 kg, P = 0.068). SODIS and control households did not differ in the microbial quality of their untreated household water over the follow-up period (P = 0.119), but E. coli concentrations in SODIS bottles were significantly lower than those in storage containers over all follow-up visits (P < 0.001). This is the first trial to show evidence of the effect of SODIS on childhood anthropometry, compared with children in the control group and should alleviate concerns expressed by some commentators that the lower rates of dysentery associated with SODIS are the product of biased reporting rather than reflective of genuinely decreased incidence.