Relative benefits of on-plot water supply over other 'improved' sources in rural Vietnam.

Access to improved water sources is rapidly expanding in rural central Vietnam. We examined one NGO-led piped water supply programme to assess the drinking water quality and health impacts of piped water systems where access to 'improved' water sources is already good. This longitudinal, prospective cohort study followed 300 households in seven project areas in Da Nang province, Vietnam: 224 households who paid for an on-plot piped water connection and 76 control households from the same areas relying primarily on 'improved' water sources outside the home. The 4-month study was intended to measure the impact of the NGO-led water programmes on households' drinking water quality and health and to evaluate system performance. We found that: (i) households connected to a piped water supply had consistently better drinking water quality than those relying on other sources, including 'improved' sources and (ii) connected households experienced less diarrhoea than households without a piped water connection (adjusted longitudinal prevalence ratio: 0.57 (95% CI 0.39-0.86, P = 0.006) and households using an 'improved' source not piped to the plot: (adjusted longitudinal prevalence ratio: 0.59 (95% CI 0.39-0.91, P = 0.018). Our results suggest that on-plot water service yields benefits over other sources that are considered 'improved' by the WHO/UNICEF Joint Monitoring Programme.

Brown J ，Hien VT ，McMahan L ，Jenkins MW ，Thie L ，Liang K ，Printy E ，Sobsey MD ... -  《-》

Water quality risks of 'improved' water sources: evidence from Cambodia.

The objective of this study was to investigate the quality of on-plot piped water and rainwater at the point of consumption in an area with rapidly expanding coverage of 'improved' water sources. Cross-sectional study of 914 peri-urban households in Kandal Province, Cambodia, between July-August 2011. We collected data from all households on water management, drinking water quality and factors potentially related to post-collection water contamination. Drinking water samples were taken directly from a subsample of household taps (n = 143), stored tap water (n = 124), other stored water (n = 92) and treated stored water (n = 79) for basic water quality analysis for Escherichia coli and other parameters. Household drinking water management was complex, with different sources used at any given time and across seasons. Rainwater was the most commonly used drinking water source. Households mixed different water sources in storage containers, including 'improved' with 'unimproved' sources. Piped water from taps deteriorated during storage (P < 0.0005), from 520 cfu/100 ml (coefficient of variation, CV: 5.7) E. coli to 1100 cfu/100 ml (CV: 3.4). Stored non-piped water (primarily rainwater) had a mean E. coli count of 1500 cfu/100 ml (CV: 4.1), not significantly different from stored piped water (P = 0.20). Microbial contamination of stored water was significantly associated with observed storage and handling practices, including dipping hands or receptacles in water (P < 0.005), and having an uncovered storage container (P = 0.052). The microbial quality of 'improved' water sources in our study area was not maintained at the point of consumption, possibly due to a combination of mixing water sources at the household level, unsafe storage and handling practices, and inadequately treated piped-to-plot water. These results have implications for refining international targets for safe drinking water access as well as the assumptions underlying global burden of disease estimates, which posit that 'improved' sources pose minimal risks of diarrhoeal diseases.

Shaheed A ，Orgill J ，Ratana C ，Montgomery MA ，Jeuland MA ，Brown J ... -  《-》

Upgrading a piped water supply from intermittent to continuous delivery and association with waterborne illness: a matched cohort study in urban India.

Ercumen A ，Arnold BF ，Kumpel E ，Burt Z ，Ray I ，Nelson K ，Colford JM Jr ... -  《-》

Intermittent slow sand filtration for preventing diarrhoea among children in Kenyan households using unimproved water sources: randomized controlled trial.

Tiwari SS ，Schmidt WP ，Darby J ，Kariuki ZG ，Jenkins MW ... -  《-》

Water safety and inequality in access to drinking-water between rich and poor households.

Yang H ，Bain R ，Bartram J ，Gundry S ，Pedley S ，Wright J ... -  《-》