Evaluation of A Point-Of Use Water Purification System (Llaveoz) in a Rural Setting of Chiapas, Mexico. J Microbiol Exp 2014, 1(3): 00015
*Corresponding author: Javier Gutierrez-Jimenez, University of Science and Arts of Chiapas, Libramiento norte poniente#1150, Col. Lajas Maciel, Tuxtla Gutierrez, Chiapas, Mexico, Tel: +52-9616170440/ 4303; E-mail: javier.gutierrez@unicach.mx
Access to potable water is a priority for highly-marginalized rural communities of Chiapas, Mexico where consumption of poorly sanitized water has fostered severe diarrheal diseases among children. Interventions aimed to reduce contaminants present in water are necessary to reduce morbidity and mortality rates. In this work we evaluated the efficiency of a point of use water purification system, Llaveoz, to eradicate total coliform (TC) bacteria and diarrheagenic E. coli (DEC) strains in 62 paired water samples obtained from households during the dry and rainy season. TC was determined by the membrane filtration method whereas DEC strains were evaluated by a multiplex PCR approach. After Llaveoz treatment, water samples collected during the dry season (N=20) had an 80.3% reduction of TC counts (p<0.05). Similarly, TC were significantly reduced (72.3%, (p<0.05)) in water samples treated during the rainy season (N=42). A total of 28 E. coli strains were isolated of which 14.3% (N=4) were identified as DEC strains (ETEC (N=2), EAEC (N=1) or EIEC (N=1)) in untreated water samples. Llaveoz-treated water did not contain DEC strains. Thus, the Llaveoz system represents an alternative method to obtain more pure water in regions where potable water sources are not available.
The Llaveoz™ water disinfection system (patent US2011/0215037 A1) consists in a plastic faucet which is placed at the base of a water container used at home for water storage; the faucet contains an ultraviolet light bulb UVC type which uses electricity (110V or 12V). Its light goes on when the faucet is opened in order to pour clean water. To eliminate suspended solids, parasites and bacteria, the faucet is connected to a microfiltration cartridge which contains polypropylene membranes with 0.1µm pore diameter. In vitro studies demonstrate that Llaveoz is able to eliminate ∼99, 100% and ∼99% of parasites, bacteria and virus, respectively. Llaveoz purification system is fabricated and distributed to rural and peri-urban communities by EOZ group, a non-profit organization funded by Flor Cassassuce with a self-funding mechanism.
Heterogeneous Effects of Information on Household Behaviors to Improve Water Quality, 2014.
Joe Brown, Georgia Institute of Technology – School of Civil and Environmental Engineering
Amar Hamoudi, Duke University – Sanford School of Public Policy
Marc Jeuland, Duke University
Gina Turrini, Duke University
Providing information about health risks only sometimes induces protective action. This raises questions about whether and how risk information is understood and acted upon, and how responses vary across contexts. We stratified a randomized experiment across two periurban areas in Cambodia, which differed in terms of socioeconomic status and infrastructure.
In one area, showing households specific evidence of water contamination altered their beliefs about health risk and increased their demand for a treatment product; in the other area, it had no effect on these outcomes. These findings highlight the importance of identifying specific drivers of responses to health risk information.
Health insurance and health environment: India’s subsidized health insurance in a context of limited water and sanitation services, 2014.
Florence McBain, Zentrum für EntwicklungsforschungCenter for Development ResearchUniversity of Bonn.
Recently, many emerging countries have established subsidized health insurance schemes to provide financial protection and support access to health care to poor households. The challenge to ensure the long term sustainability of such schemes is huge. In this paper, the impact of the health environment on the long term sustainability of a health insurance is explored, focusing on water and sanitation. India offers an interesting case to explore this question.
Indeed, since 2008 India launched a fully subsidized health insurance Rashtriya Swasthya Bima Yojana (RSBY) in a context where 56% of its population does not have access to safe sanitation and 8% do not have access to safe water (JMP, 2012). A framework is proposed linking water supply and sanitation; health status of the insured population; health insurance and the productivity of households. Next, based on a literature review, the outcomes of investments in water and sanitation and health insurance are reviewed and the potential synergies and trade-offs of combing these investments are explored. In a last section, the case of India is analysed in detail, with international comparisons and further research lines are proposed.
Looking beyond Technology: An Integrated Approach to Water, Sanitation and Hygiene in Low Income Countries. Env Sci Tech, July 2014.
Elizabeth Tilley, Linda Strande, Christoph Lüthi, Hans-Joachim Mosler, Kai M. Udert, Heiko Gebauer, and Janet G. Hering
Despite investment stimulated by the Millennium Development Goals (MDGs), sanitation-related diseases, such as diarrhea, cholera and typhus, remain a leading cause of death of children under five in low-income countries. Prevention of diarrhea requires a combination of access to safe drinking water, good hygiene and adequate sanitation. The sanitation problem has proven to be particularly intractable, demonstrating the shortcomings of past efforts that have focused on increasing access to toilets.
An alternative view positions the toilet within a service chain that extends to the final point of disposal or end-use of excreta-derived products. An integrated perspective that addresses improved planning, takes advantage of economic opportunities, incorporates specialized technology, and follows-up with behavior change could help to ensure not only access but also sustainable use, operation and maintenance of water, sanitation and hygiene interventions.
Association between Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study (GEMS) and Types of Handwashing Materials Used by Caretakers in Mirzapur, Bangladesh. Am J Trop Med Hyg. 2014 Jul 2;91(1):181-9.
Authors: Baker KK, et al.
Abstract: Handwashing practices among caretakers of case and control children < 5 years of age enrolled in the Global Enteric Multicenter Study in Mirzapur, Bangladesh were characterized and analyzed for association with moderate-to-severe diarrhea. Soap or detergent ownership was common, yet 48% of case and 47.7% of control caretakers also kept ashes for handwashing, including 36.8% of the wealthiest households. Soap, detergent, and ash were used for multiple hygiene purposes and were kept together at handwashing areas. Caretakers preferred soap for handwashing, but frequently relied on ash, or a detergent/ash mixture, as a low-cost alternative. Moderate-to-severe diarrhea was equally likely for children of caretakers who kept soap versus those who kept ash (matched OR = 0.91; 0.62-1.32). Contact with ash and water reduced concentrations of bacterial enteropathogens, without mechanical scrubbing. Thus, washing hands with ash is a prevalent behavior in Mirzapur and may help diminish transmission of diarrheal pathogens to children.
Below are abstracts and links to the full-text of articles in the August 2014 issue of Tropical Medicine and International Health. 
Focus on the Global Burden of Disease from Water While the methods of Global Burden of Disease (GBD) study continue to evolve, recent changes raise questions about the basis of new estimates of the risk associated with water, sanitation and hygiene and warrant consideration of alternative approaches.
- Inadequate water, sanitation and hygiene are estimated to have caused 842,000 deaths from diarrhoea in 2012, i.e., 1.5% of deaths worldwide. These include 361,000 deaths of children under five years.
- A systematic review of the global prevalence of handwashing with soap and its effect on diarrhoeal diseases estimates that only 19% of the world’s population washes hands with soap after contact with excreta and that handwashing reduces the risk of diarrhoeal disease by 23%–40%.
- Based on over 300 studies from a systematic review, an estimated 1.1 billion people are exposed to a drinking water source of moderate to high risk.
- A meta-regression shows that risks of diarrhoea from inadequate drinking water and sanitation could be reduced considerably through targeted interventions. Risk differences depend on type of intervention.
1 – Authors: Clasen, Thomas, Pruss-Ustun, Annette, Mathers, Colin D., et al. TI - Estimating the impact of unsafe water, sanitation and hygiene on the global burden of disease: evolving and alternative methods Abstract - http://onlinelibrary.wiley.com/doi/10.1111/tmi.12330/abstract AB - The 2010 global burden of disease (GBD) study represents the latest effort to estimate the global burden of disease and injuries and the associated risk factors. Like previous GBD studies, this latest iteration reflects a continuing evolution in methods, scope and evidence base. Since the first GBD Study in 1990, the burden of diarrhoeal disease and the burden attributable to inadequate water and sanitation have fallen dramatically. While this is consistent with trends in communicable disease and child mortality, the change in attributable risk is also due to new interpretations of the epidemiological evidence from studies of interventions to improve water quality. To provide context for a series of companion papers proposing alternative assumptions and methods concerning the disease burden and risks from inadequate water, sanitation and hygiene, we summarise evolving methods over previous GBD studies. We also describe an alternative approach using population intervention modelling. We conclude by emphasising the important role of GBD studies and the need to ensure that policy on interventions such as water and sanitation be grounded on methods that are transparent, peer-reviewed and widely accepted. 2 – Authors: Prüss-Ustün, Annette, Bartram, Jamie, Clasen, Thomas, et al. TI - Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries
Objective - To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. Methods - For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. Results - In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. Conclusions - This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. [click to continue…]
Synthetic organic water contaminants in developing communities: an overlooked challenge addressed by adsorption with locally generated char. Journal of Water, Sanitation and Hygiene for Development, In Press
- Order info or contact Joshua Kearns at the email below to request a reprint.
Joshua P. Kearns, Detlef R. U. Knappe and R. Scott Summers
Department of Civil, Environmental, & Architectural Engineering, University of Colorado-Boulder, 1111 Engineering Dr, ECOT 441, UCB 428, Boulder, CO 80309, USA E-mail: joshua.kearns@colorado.edu
Department of Civil, Construction, & Environmental Engineering, North Carolina State University, 2501 Stinson Dr, Campus Box 7908, Raleigh, NC 27695, USA
Chemical contamination of drinking water sources is a worldwide problem. However, few locally managed, sustainable, and low-cost on-site treatment technologies are available in rural, remote, and emergency/disaster relief/humanitarian crisis situations. Char filter-adsorbers have been used to treat drinking water for thousands of years and are still widely used today. Our studies show that some chars produced by traditional means from a range of feedstocks develop favorable sorption properties for uptake of 2,4-dichlorophenoxyacetic acid (2,4-D), a prevalent herbicide and water contaminant. However, more energy efficient, environmentally sustainable and scalable production of consistent highly sorptive chars can be accomplished with biomass gasification. Our laboratory studies demonstrate that locally produced char adsorbents derived from surplus agricultural and forestry biomass are effective for adsorbing 2,4-D. A year-long study of field-scale application of chars in Thailand is also presented. Based on these studies we present design recommendations for integrating char adsorbers into low-cost, multi-barrier treatment trains for on-site water provision.
Marketing Household Water Treatment: Willingness to Pay Results from an Experiment in Rural Kenya. Water 2014, 6, 1873-1886; doi:10.3390/w6071873.
Annalise G. Blum 1, Clair Null 2 and Vivian Hoffmann 3,*
1 Department of Environmental Sciences & Engineering, University of North Carolina at Chapel Hill, 148 Rosenau Hall, Chapel Hill, NC 27516, USA; E-Mail: annalise@live.unc.edu
2 Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA; E-Mail: clair.null@emory.edu
3 International Food Policy Research Institute, 2033 K Street NW, Washington, DC 20006, USA
* Author to whom correspondence should be addressed; E-Mail: v.hoffmann@cgiar.org
Despite increasing availability of household water treatment products, demand in developing countries remains low. Willingness to pay for water treatment products and factors that affect demand are not well understood. In this study, we estimate willingness to pay for WaterGuard, a dilute chlorine solution for point-of-use water treatment, using actual purchase decisions at randomly assigned prices. Secondly, we identify household characteristics that are correlated with the purchase decision. Among a sample of 854 respondents from 107 villages in rural Kenya, we find that mean willingness to pay is approximately 80% of the market price. Although only 35% of sample households purchased WaterGuard at the market price, 67% of those offered a 50% discount purchased the product.
A marketing message emphasizing child health did not have a significant effect on purchase behavior, overall or among the subset of households with children under five. These findings suggest that rural Kenyans are willing to pay for WaterGuard at low prices but are very sensitive to increasing price. Households with young children that could benefit the most from use of WaterGuard do not appear to be more likely to purchase the product, and a marketing message designed to target this population was ineffective.
MS2 Bacteriophage Reduction and Microbial Communities in Biosand Filters. Environ Sci Technol. 2014 Jun.
Wang H, et al.
This study evaluated the role of physical and biological filter characteristics on the reduction of MS2 bacteriophage in biosand filters (BSFs). Three full-scale concrete Version 10 BSFs, each with a 55 cm sand media depth and a 12 L charge volume, reached 4 log10 reduction of MS2 within 43 days of operation. A consistently high reduction of MS2 between 4 log10 and 7 log10 was demonstrated for up to 294 days. Further examining one of the filters revealed that an average of 2.8 log10 reduction of MS2 was achieved within the first 5 cm of the filter, and cumulative virus reduction reached an average of 5.6 log10 after 240 days. Core sand samples from this filter were taken for protein, carbohydrate, and genomic extraction. Higher reduction of MS2 in the top 5 cm of the sand media (0.56 log10 reduction per cm vs 0.06 log10 reduction per cm for the rest of the filter depth) coincided with greater diversity of microbial communities and increased concentrations of carbohydrates.
In the upper layers, “Candidatus Nitrosopumilus maritimus” and “Ca. Nitrospira defluvii” were found as dominant populations, while significant amounts of Thiobacillus-related OTUs were detected in the lower layers. Proteolytic bacterial populations such as the classes Sphingobacteria and Clostridia were observed over the entire filter depth. Thus, this study provides the first insight into microbial community structures that may play a role in MS2 reduction in BSF ecosystems. Overall, besides media ripening and physical reduction mechanisms such as filter depth and long residence time (45 min vs 24 ± 8.5 h), the establishment of chemolithotrophs and proteolytic bacteria could greatly enhance the reduction of MS2.
The toilet tripod: Understanding successful sanitation in rural India. Health Place. 2014 Jun 19.
O’Reilly K, Louiss׳ E.
Building toilets and getting people to use them is critical for public health. We deployed a political ecology approach specifically to identify the multi-scalar political, economic, and environmental factors influencing toilet adoption in rural India. The research used ethnographic and technical methods in rural villages of West Bengal and Himachal Pradesh over the period September 2012 to May 2013. The elements of successful sanitation adoption depended on three factors (i.e., toilet tripod):
- (1) multi-scalar political will on the part of both government and NGOs over the long term;
- (2) proximate social pressure, i.e., person-to-person contact between rural inhabitants and toilets;
- (3) political ecology, i.e., assured access to water, compatible soil type, and changing land use.
This research contributes to studies of sustainable development and global public health by developing a theory and framework for successful sanitation.
