This video describes a forthcoming paper in PLoS Medicine by Daniel Mäusezahl and colleagues. The paper is going to be published on the 18th August; it's under embargo until August 17th at 5PM Pacific Time.
Citation: Maeusezahl D, Christen A, Duran Pacheco G, Tellez FA, Iriarte M, et al. (2009) Solar Drinking Water Disinfection (SODIS) to Reduce Childhood Diarrhoea in Rural Bolivia: A Cluster-Randomized, Controlled Trial. PLoS Med 6(8): e1000125. doi:10.1371/journal.pmed.1000125
For the press release and more details, please contact press@plos.org
Abstract
Background
Solar drinking water disinfection (SODIS) is a low-cost, point-of-use water purification method that has
been disseminated globally. Laboratory studies suggest that SODIS is highly efficacious in inactivating
waterborne pathogens. Previous field studies provided limited evidence for its effectiveness in reducing
diarrhoea.
Methods and Findings
We conducted a cluster-randomized controlled trial in 22 rural communities in Bolivia to evaluate the
effect of SODIS in reducing diarrhoea among children under the age of 5 y. A local nongovernmental
organisation conducted a standardised interactive SODIS-promotion campaign in 11 communities
targeting households, communities, and primary schools. Mothers completed a daily child health diary for
1 y. Within the intervention arm 225 households (376 children) were trained to expose water-filled
polyethyleneteraphtalate bottles to sunlight. Eleven communities (200 households, 349 children) served
as a control. We recorded 166,971 person-days of observation during the trial representing 79.9% and
78.9% of the total possible person-days of child observation in intervention and control arms,
respectively. Mean compliance with SODIS was 32.1%. The reported incidence rate of gastrointestinal
illness in children in the intervention arm was 3.6 compared to 4.3 episodes/year at risk in the control
arm. The relative rate of diarrhoea adjusted for intracluster correlation was 0.81 (95% confidence interval
0.59–1.12). The median length of diarrhoea was 3 d in both groups.
Conclusions
Despite an extensive SODIS promotion campaign we found only moderate compliance with the
intervention and no strong evidence for a substantive reduction in diarrhoea among children. These results
suggest that there is a need for better evidence of how the well-established laboratory efficacy of this
home-based water treatment method translates into field effectiveness under various cultural settings and
intervention intensities. Further global promotion of SODIS for general use should be undertaken with
care until such evidence is available.
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