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&lt；.0001) 控制社区。保护性关联性略高于 血性腹泻(25%，p&lt；0.05)和持续性腹泻(26%，p&lt；.0001)， 这表明干预可能不仅降低了 腹泻也是腹泻的严重程度。相比之下，不会对 呼吸道感染的发生很明显，表明 干预社区中腹泻的下降不太可能是 由于确定的偏差。特别有趣的是， 干预社区人均用水量明显增加。 消耗，但新的水泵继续产生的水 被粪便大肠菌污染。有数据表明，敬礼 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。 分析目前仍在继续。

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. 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 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.