High Adherence Is Necessary to Realize Health Gains from Water Quality Interventions
High Adherence Is Necessary to Realize Health Gains from Water Quality Interventions
复制标题
要通过水质干预措施实现健康收益，必须高度坚持
作者：
Joe Brown;T. Clasen
背景安全饮用水对健康至关重要。在现有水源不安全的情况下，建议使用家庭水处理(HWT)来改善饮用水的获取。然而，有关对HWT依从性较低的报告可能会限制这种方法的有效性。方法和发现我们构建了一个定量的微生物风险模型，以预测水质干预带来的健康收益，该模型基于对处理前水质、减少细菌、病毒和原生动物寄生虫的治疗效果、坚持治疗干预措施、每人每天消耗的水量以及其他变量的一系列假设。根据平均估计，假设处理前水质中等差，这是风险来源和高处理依从性(90%的消耗水经过处理)，随着获得安全水的机会增加，每100,000人年可避免500个以上的DALY。坚持从100%下降到90%将使预期的健康收益减少高达96%，当处理前的水质具有更高的风险时，下降幅度最大。结论高依从性是实现HWT潜在健康益处的关键。
Background Safe drinking water is critical for health. Household water treatment (HWT) has been recommended for improving access to potable water where existing sources are unsafe. Reports of low adherence to HWT may limit the usefulness of this approach, however. Methods and Findings We constructed a quantitative microbial risk model to predict gains in health attributable to water quality interventions based on a range of assumptions about pre-treatment water quality; treatment effectiveness in reducing bacteria, viruses, and protozoan parasites; adherence to treatment interventions; volume of water consumed per person per day; and other variables. According to mean estimates, greater than 500 DALYs may be averted per 100,000 person-years with increased access to safe water, assuming moderately poor pre-treatment water quality that is a source of risk and high treatment adherence (>90% of water consumed is treated). A decline in adherence from 100% to 90% reduces predicted health gains by up to 96%, with sharpest declines when pre-treatment water quality is of higher risk. Conclusions Results suggest that high adherence is essential in order to realize potential health gains from HWT.