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，其中包括 大约10，000人，被随机分配到 接受干预（N=10）或不接受干预（N=10）。 的 干预措施包括提供印度Mark II型管井， 家庭厕所，以及一套教育材料，强调 个人卫生和用水行为。 受影响的评估 干预，这些村庄的所有家庭都被跟踪， 在一年的随访期内进行纵向监测。 虽然 基线发病率（每1000人-天， 随访）在3岁以下儿童中， 干预（29）和控制（29）社区，零时间率后， 与对照组相比，干预组腹泻减少17%（p <0.0001）， 控制社区。 保护性协会略高， 血性腹泻（25%，P <.05）和持续性腹泻（26%，P <.05） 0.0001），这表明干预可能不仅减少了 腹泻的风险以及腹泻的严重程度。 相比之下， 对呼吸道感染发生的影响是明显的，表明 在干预社区腹泻的下降并不是 这可能是由于确认偏差。 特别令人感兴趣的是 干预社区的人均收入显著增加， 水的消耗，但新的水泵继续生产水， 被粪大肠菌群污染了 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。 分析将在1994财政年度继续进行。

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.