Household Water Disinfection in Cholera Prevention

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Household Water Disinfection in Cholera Prevention

Household Water Disinfection in Cholera Prevention 

INFORMATION FOR ACTION FROM THE WATER AND SANITATION FOR HEALTH PROJECT 

In January 1991, cholera appeared in Peru after an absence of nearly 100 years and spread rapidly throughout Latin America and the Caribbean, creating a public health emergency. One very effective emergency measure, household disinfection of water, is the subject of this technical note, written primarily for U. S. Agency for International Development (A.I.D.) health officers and appropriate national health personnel in countries where cholera is endemic or epidemic or other waterbome diseases are prevalent. Household disinfection of water can make a significant contribution to protecting people in situations where water supplies are contaminated. Household disinfection outreach and extension campaigns must instruct people in threatened communities in how to disinfect their household water and motivate them to do so. National-level commitment is crucial for such campaigns to be effective. Recent experience in Peru provides an example of how a national policy for household disinfection may be established and successfully implemented. Following the outbreak of cholera in early 1991, Peru's Ministry of Health made a policy at the national level to distribute disinfection packets for disinfecting water in the home. Collaboration was enlisted with the Ministry of Housing and Construction, and the Pan American Center for Sanitary Engineering and Environmental Science (CEPIS), located in Lima. Technical assistance was extended to regional and local government agencies to organize cholera committees through community health centers. These committees distributed the disinfection materials to households and also provided demonstrations on how to purify water in the home. To be successful, household-level prevention efforts must be part of a comprehensive "package" of anti-cholera interventions, such as programs and policies that encourage oral rehydration therapy, breastfeeding of infants, safe and sanitary excreta disposal, personal and household hygiene, and disinfection of drinking water. National-level support for education and training programs at the community and individual levels is also essential. There are more than 20 serious waterbome diseases in addition to cholera. And while their impact on the mortality of infants and small children is most visible, they undermine families' overall well-being and adult productivity as well. Anecdotal evidence of a significant connection between household disinfection and diarrhea morbidity is being gathered in Guatemala, where health officers observed a significant decline in diarrheal illness and death during a recent hygiene education campaign directed against cholera. As the disease receded, however, the motivation to continue disinfection dropped and diarrhea returned to previous levels.

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