Zambia
Source:
- PLoS ONE, Nov 6, 2012
Rachel Peletz, et al.
Summary:
- Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia
Background: Unsafe drinking water presents a particular threat to people living with HIV/AIDS (PLHIV) due to the increased risk of opportunistic infections, diarrhea-associated malabsorption of essential nutrients, and increased exposure to untreated water for children of HIV-positive mothers who use replacement feeding to reduce the risk of HIV transmission. This population may particularly benefit from an intervention to improve water quality in the home.
Methods and Findings: We conducted a 12-month randomized, controlled field trial in Zambia among 120 households with children ,2 years (100 with HIV-positive mothers and 20 with HIV-negative mothers to reduce stigma of participation) to assess a high-performance water filter and jerry cans for safe storage. Households were followed up monthly to assess use, drinking water quality (thermotolerant coliforms (TTC), an indicator of fecal contamination) and reported diarrhea (7-day recall) among children ,2 years and all members of the household. Because previous attempts to blind the filter have been unsuccessful, we also assessed weight-for-age Z-scores (WAZ) as an objective measure of diarrhea impact. Filter use was high, with 96% (596/620) of household visits meeting the criteria for users. The quality of water stored in intervention
households was significantly better than in control households (3 vs. 181 TTC/100 mL, respectively, p,0.001). The intervention was associated with reductions in the longitudinal prevalence of reported diarrhea of 53% among children ,2 years (LPR = 0.47, 95% CI: 0.30–0.73, p = 0.001) and 54% among all household members (LPR = 0.46, 95% CI: 0.30–0.70, p,0.001). While reduced WAZ was associated with reported diarrhea (20.26; 95% CI: 20.37 to 20.14, p,0.001), there was no difference in WAZ between intervention and control groups.
Conclusion: In this population living with HIV/AIDS, a water filter combined with safe storage was used correctly and consistently, was highly effective in improving drinking water quality, and was protective against diarrhea.
Keywords:
Evidence Base Household Water Treatment & Storage
Source:
- Peletz R, Simunyama M, Sarenje K, Baisley K, Filteau S, et al. (2012) Assessing Water Filtration and Safe Storage in Households with Young Children of HIV-Positive Mothers: A Randomized, Controlled Trial in Zambia. PLoS ONE 7(10): e46548. doi:10.1371/journal.pone.0046548
Summary:
- Background - Unsafe drinking water presents a particular threat to people living with HIV/AIDS (PLHIV) due to the increased risk of opportunistic infections, diarrhea-associated malabsorption of essential nutrients, and increased exposure to untreated water for children of HIV-positive mothers who use replacement feeding to reduce the risk of HIV transmission. This population may particularly benefit from an intervention to improve water quality in the home.
Methods and Findings - We conducted a 12-month randomized, controlled field trial in Zambia among 120 households with children <2 years (100 with HIV-positive mothers and 20 with HIV-negative mothers to reduce stigma of participation) to assess a high-performance water filter and jerry cans for safe storage. Households were followed up monthly to assess use, drinking water quality (thermotolerant coliforms (TTC), an indicator of fecal contamination) and reported diarrhea (7-day recall) among children <2 years and all members of the household. Because previous attempts to blind the filter have been unsuccessful, we also assessed weight-for-age Z-scores (WAZ) as an objective measure of diarrhea impact. Filter use was high, with 96% (596/620) of household visits meeting the criteria for users. The quality of water stored in intervention households was significantly better than in control households (3 vs. 181 TTC/100 mL, respectively, p<0.001). The intervention was associated with reductions in the longitudinal prevalence of reported diarrhea of 53% among children <2 years (LPR = 0.47, 95% CI: 0.30–0.73, p = 0.001) and 54% among all household members (LPR = 0.46, 95% CI: 0.30–0.70, p<0.001). While reduced WAZ was associated with reported diarrhea (−0.26; 95% CI: −0.37 to −0.14, p<0.001), there was no difference in WAZ between intervention and control groups.
Conclusion - In this population living with HIV/AIDS, a water filter combined with safe storage was used correctly and consistently, was highly effective in improving drinking water quality, and was protective against diarrhea.
Keywords:
Household Water Treatment & Storage
Source:
- Kangamba M et al. 2006. Baltimore, MD. Catholic Relief Services
Summary:
- In Zambia, HIV/AIDS is still approached primarily as a health issue, and therefore, interventions focus mainly on prevention and treatment. The provision of affordable, accessible and reliable public services is essential in supporting health maintenance and reducing stress for people infected and affected with HIV/AIDS. Reliable delivery of good-quality water and sound basic sanitation are critical in reducing exposure to pathogens to which HIV-positive people are particularly vulnerable. Where water services are inadequate or inaccessible, time and monetary costs of access to good quality water in sufficient quantities are high, particularly for HIV-infected people and their caregivers. An assessment was commissioned by the WHO with the goal of producing evidence-based guidance on water and sanitation needs in home-based care strategies, particularly in resource-poor situations and to develop practical and strategic recommendations to be made at the programme and policy levels, while identifying the most critical measures to be taken by the health sector and the water and sanitation sector to provide short- and medium-term solutions in the area of water, sanitation and hygiene support to home-based care.
Keywords:
Accessing Water Evidence Base Home-Based Care Policy Programming Guidance Sanitation/Feces Disposal
Source:
- Kidd, R & Clay, S. 2003.
Summary:
- This toolkit was written by AIDS activists from over 50 nongovernmental
organizations in Ethiopia, Tanzania and Zambia. They participated in workshops where they explored the implications of stigma and designed the exercises on different aspects of stigma. The Toolkit is a resource collection of participatory educational exercises for use in raising awareness and promoting action to challenge HIV stigma. Trainers can select from the exercises to plan their own courses for different target groups—both AIDS
professionals and community groups.
Keywords:
Stigma Training Resources
