Epidemiology and Infection

Diarrhoea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy

R. E. QUICK a1c1, L. V. VENCZEL a2, E. D. MINTZ a1, L. SOLETO a3, J. APARICIO a3, M. GIRONAZ a3, L. HUTWAGNER a1, K. GREENE a1, C. BOPP a1, K. MALONEY a1, D. CHAVEZ a4, M. SOBSEY a2 and R. V. TAUXE a1
a1 Foodborne and Diarrhoeal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, Public Health Service, U.S. Department of Health and Human Services
a2 University of North Carolina, Chapel Hill, NC
a3 Centro Nacional de Enfermedades Tropicales, Santa Cruz, Bolivia
a4 Villa Cochabamba Health Center, Montero, Bolivia


A novel water quality intervention that consists of point-of-use water disinfection, safe storage and community education was field tested in Bolivia. A total of 127 households in two periurban communities were randomized into intervention and control groups, surveyed and the intervention was distributed. Monthly water quality testing and weekly diarrhoea surveillance were conducted. Over a 5-month period, intervention households had 44% fewer diarrhoea episodes than control households (P=0·002). Infants <1 year old (P=0·05) and children 5–14 years old (P=0·01) in intervention households had significantly less diarrhoea than control children. Campylobacter was less commonly isolated from intervention than control patients (P=0·02). Stored water in intervention households was less contaminated with Escherichia coli than stored water in control households (P<0·0001). Intervention households exhibited less E. coli contamination of stored water and less diarrhoea than control households. This promising new strategy may have broad applicability for waterborne disease prevention.

(Accepted September 10 1998)

c1 Author for correspondence: Foodborne and Diarrheal Diseases Branch, M/S A-38, Centers for Disease Control and Prevention, Atlanta GA 30333, USA.