Scientists Validate Simple Device Can Decrease Diarrhea Rates in Children

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An international team of researchers including a Stanford epidemiologist, Prof. Stephen Luby, have recently found that a simple device called Aquatabs Flo can decrease the rates of diarrhea in children.

Aquatabs Flo is a low cost water purification system. It brings the chemistry of Aquatabs from “point-of-use” so that water is purified at “point of entry”.

According to the results published in The Lancet Global Health, this low cost water treatment device provides good-tasting water and avoids the need for in-home treatment.

The World Health Organisation (WHO) report shows that diarrhea kills an under five child every minute on average. The apex health institution added that the disease is the second leading cause of death for children globally; it could become even more difficult to control as poor urban areas with limited clean water access expand.

Study senior author, Stephen Luby, a professor of Medicine in the Division of Infectious Diseases and Geographic Medicine at the Stanford School of Medicine revealed that in developing countries, few cities are able to maintain fully pressurized water systems that consistently pump water around the clock.

“Even if it is safe at the source, water in these systems is at risk of becoming contaminated while sitting in pipes. About 1 billion people who access water via piped systems receive water that does not meet international standards for safety,” Luby added.

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image of a young boy fetching water from the community borehole

The Standard epidemiologist said, “group level water treatment among people who share a water supply removes the individual burden on households to treat their own water, so, it offers the prospect for extending safe drinking water to vulnerable slum residents globally.”

Study lead author Amy Pickering, an assistant professor of civil and environmental engineering at Tufts University explained “the study demonstrated that this simple, electricity-independent technology could be transformative in scaling up water treatment in slums and reducing child diarrhea, without requiring people to do anything differently when they collect their drinking water.”

Working in two poor communities of Dhaka, Bangladesh, the researchers tested a way of treating water, called Aquatabs Flo, that works at community pumps rather than in the home. It requires no electricity and automatically doses a precise amount of chlorine into water as it flows through the device. The chlorine lasts long enough to protect water stored in containers against recontamination.

The researchers tested the device by having it deliver chlorine in some communities and Vitamin C in others. Out of 1,000 children, the ones who received the chlorinated water had 23 percent lower rates of diarrhea. While the result may seem obvious, previous studies had been ambiguous either because people didn’t consistently use the household chlorination systems being tested or because they weren’t able to compare to communities without water treatment.

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The device was particularly effective in children living in an urban setting, which the researchers suggest could be due to a few different causes. One is that water in urban settings often spends more time in unpressurized pipes. Also, before the chlorine treatment, nearly 90 percent of taps in that setting were contaminated with E coli, almost twice the rate of the more rural study area.

Finally, the two locations contained different pathogens, some of which could be resistant to chlorine. Either way, the results suggested that a device that delivers a precise low-dose of chlorine can purify water while tasting good enough to drink.

The study was an outgrowth of the Lotus Water project—a joint effort led by Stanford’s Program on Water, Health and Development—which received early funding from the Stanford Woods Institute for the Environment. The project aims to provide water disinfection services through a business model that relies on monthly payments from landlords, who typically own shared water points in Dhaka. The team’s earlier research indicated that slum residents are willing to pay higher rents in exchange for higher-quality water. Linking the device’s lease to service payments would hold landlords accountable to their tenants.

Although Aquatabs Flo is currently only compatible with water points connected to storage tanks, Tufts and Stanford are collaborating with an industry partner to commercialize a chlorine doser compatible with any tap.

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