Differences in field effectiveness and adoption between a novel automated chlorination system and household manual chlorination of drinking water in Dhaka, Bangladesh: a randomized controlled trial

PLoS One. 2015 Mar 3;10(3):e0118397. doi: 10.1371/journal.pone.0118397. eCollection 2015.

Abstract

The number of people served by networked systems that supply intermittent and contaminated drinking water is increasing. In these settings, centralized water treatment is ineffective, while household-level water treatment technologies have not been brought to scale. This study compares a novel low-cost technology designed to passively (automatically) dispense chlorine at shared handpumps with a household-level intervention providing water disinfection tablets (Aquatab), safe water storage containers, and behavior promotion. Twenty compounds were enrolled in Dhaka, Bangladesh, and randomly assigned to one of three groups: passive chlorinator, Aquatabs, or control. Over a 10-month intervention period, the mean percentage of households whose stored drinking water had detectable total chlorine was 75% in compounds with access to the passive chlorinator, 72% in compounds receiving Aquatabs, and 6% in control compounds. Both interventions also significantly improved microbial water quality. Aquatabs usage fell by 50% after behavioral promotion visits concluded, suggesting intensive promotion is necessary for sustained uptake. The study findings suggest high potential for an automated decentralized water treatment system to increase consistent access to clean water in low-income urban communities.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Bangladesh
  • Child
  • Diarrhea / economics
  • Diarrhea / prevention & control*
  • Drinking Water / analysis*
  • Family Characteristics
  • Female
  • Follow-Up Studies
  • Halogenation
  • Humans
  • Male
  • Poverty
  • Water Pollution / analysis*
  • Water Pollution / economics
  • Water Pollution / statistics & numerical data
  • Water Purification / instrumentation
  • Water Purification / methods*
  • Water Quality
  • Water Supply / methods

Substances

  • Drinking Water

Grants and funding

Funding was provided by a grant to the International Centre for Diarrhoeal Disease Research, Bangladesh from the United States Agency for International Development; the United States Environmental Protection Agency P3: People, Prosperity and the Planet program (EPA agreement SU83531301); and a research grant from the Vice Provost for Undergraduate Education at Stanford University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.