EVALUATION OF A WATER-SANITATION INTERVENTION IN EGYPT

这一实地项目的目的是评估一个综合的 水卫生干预对儿童腹泻发生率的影响， 居住在艾斯尤特的研究人群的其他目标结局 上埃及省。 20个村庄，总共包括大约2000名居民。 10，000人被随机分配接受干预（N=10） 或无干预（N=10）。 干预措施包括提供 印度Mark II管井和家庭厕所，以及 强调个人卫生和用水行为的教育包。 到 评估干预措施的影响，这些村庄的所有家庭 在为期一年的随访期间， 期 虽然基线发病率的疟疾发作（每1000人- 3岁以下儿童的随访天数）相似， 干预（29）和控制（29）社区，零时间率后， 腹泻减少17%（p<.0001），在干预相对于 控制社区。 保护性协会略高， 血性腹泻（25%，p<0.05）和持续性腹泻（26%，p<0.0001）， 这表明，干预可能不仅降低了 腹泻的严重程度也是如此。 相比之下， 呼吸道感染的发生是明显的，表明 干预社区腹泻的下降不太可能是 由于确认偏差。 特别令人感兴趣的是， 干预社区的人均用水量显著增加， 消费，但新泵继续生产水， 被粪大肠菌群污染 这些数据表明， 干预的效果可能部分是通过增加 水的消耗，虽然水本身被粪便污染。 分析工作仍在继续。

The purpose of this field project is to evaluate the impact of a combined water-sanitation intervention on the occurrence of pediatric diarrhea and other targeted outcomes in a study population residing in the Assiut governorate of Upper Egypt. Twenty villages, which together included a population of approximately 10,000 persons, were randomly assigned to receive the intervention (N=10) or no intervention (N=10). The intervention consisted of provision of India Mark II tubewells and household latrines, together with an educational package stressing personal hygiene and water behaviors. To assess the impact of the intervention, all families in these villages were followed with logitudinal surveillance during a one-year follow-up period. Although the baseline incidence of diarrheal episodes (per 1000 person- days of follow-up) in children under three years of age was similar in intervention (29) and control (29) communities, after zero-time rates of diarrhea decreased 17% (p<.0001) in the intervention relative to the control communities. Protective associations were slightly higher for bloody diarrhea (25%, p<.05) and persistent diarrhea (26%, p<.0001), suggesting that the intervention might have reduced not only the risk of diarrhea but also the severity of diarrhea. In contrast, no impact on the occurrence of respiratory infections was evident, indicating that the decline of diarrhea in the intervention communities was not likely to be due to ascertainment bias. It was of particular interest that intervention communities exhibited a marked increase of per capita water consumption, but that the new pumps continued to produce water that was contaminated by fecal coliforms. There data suggest that the salutory effect of the intervention may have been mediated, in part, by increased water consumption, though the water itself was fecally contaminated. Analyses are now continuing.