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，人口约10 000人 随机分配10人接受干预或不接受干预 干预（N=10）。 干预措施包括提供印度 马克二号管井和家庭厕所，以及教育设施 包装强调个人卫生和水的行为。 评估 干预的影响，这些村庄的所有家庭都被跟踪 在一年的随访期内进行loglogarithm监测。 虽然基线的腹泻发病率（每千人 3岁以下儿童的随访（人-天）为 干预（29）和对照（29）社区相似， 干预后腹泻的零时间率下降了17%（p<.0001） 相对于控制社区。 保护协会是 出血性腹泻（25%，p<0.05）和持续性腹泻略高 (26%，p<.0001），表明干预可能降低了 不仅要考虑腹泻的风险，还要考虑腹泻的严重程度。 在 相比之下，对呼吸道感染的发生没有影响， 很明显，这表明在干预中腹泻的下降 社区不太可能是由于查明偏见。 的是 特别关注的是，干预社区表现出明显的 人均用水量增加，但新的水泵 继续生产被粪大肠菌群污染的水。 这些数据表明，干预的saltingeffect可能具有 部分是由于水的消耗量增加，尽管水 本身就被粪便污染了 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. 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.