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，总人口约10,000人 这些人被随机分配接受干预(N=10)或不接受干预 干预(N=10)。干预措施包括向印度提供 Mark II管井和家用厕所，以及一个教育 强调个人卫生和水上行为的套餐。要评估 在干预的影响下，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。 尽管腹泻发作的基线发病率(每1000例 3岁以下儿童的随访期)是 干预(29)和对照(29)社区相似，在 在干预中，腹泻的零时率下降了17%(p&lt；.0001) 相对于对照社区。保护性协会是 出血性腹泻(25%，p&lt；0.05)和持续性腹泻的比例略高 (26%，p&lt；.0001)，这表明干预可能已经减少了 不仅有腹泻的风险，而且还有腹泻的严重程度。在……里面 相比之下，对呼吸道感染的发生没有影响 明显，说明在干预中腹泻的下降 社区不太可能是由于确定偏差。它是在 特别是干预社区表现出明显的兴趣 人均用水量增加，但新的水泵 继续生产被粪便大肠菌污染的水。 这些数据表明，干预的有益效果可能会 部分是由于用水量的增加，尽管水 它本身就被粪便污染了。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.