EVALUATION OF A WATER-SANITATION INTERVENTION IN EGYPT

该实地项目的目的是评估联合行动的影响 饮水卫生干预对儿童腹泻发病的影响 居住在Assiut的研究人群的其他目标结果 上埃及的一个省。20个村庄，其中包括一个 大约10,000人的人口被随机分配到 接受干预(N=10)或不干预(N=10)。这个 干预措施包括提供印度马克二号管井和 家庭厕所，以及一个教育方案，强调 个人卫生和饮水行为。以评估该计划的影响 干预后，这些村庄的所有家庭都接受了 在一年的随访期内进行纵向监测。虽然 腹泻发作的基线发病率(每1000人日 3岁以下儿童的随访率与 干预(29)和控制(29)社区，零时率后 与干预措施相比，干预期间腹泻减少了17%(p<0.0001 控制社区。保护性关联性略高于 血性腹泻(25%，p<0.05)和持续性腹泻(26%，p<0.05 (0001)，这表明干预可能不仅减少了 腹泻的风险，也是腹泻的严重程度。相比之下，没有 对呼吸道感染发生的影响是明显的，表明 在干预社区中腹泻的下降并没有 很可能是由于确定偏差所致。它特别令人感兴趣 干预社区显示出人均 用水量，但新的水泵继续产生 被粪便中的大肠菌污染。有数据表明，这种有益的 干预的效果可能在一定程度上通过增加 尽管水本身被粪便污染，但水的消耗量仍然很低。 分析工作将在2014财年继续进行。

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. 20 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 longitudinal 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 less than .0001) in the intervention relative to the control communities. Protective associations were slightly higher for blood diarrhea (25%, p less than .05) and persistent diarrhea (26%, p less than .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 salutary effect of the intervention may have been mediated, in part, by increased water consumption, though the water itself was fecally contaminated. Analyses will continue in FY94.