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Automatic device to deliver chlorine in public taps reduces child diarrhoea

Parenting Medibulletin


'Study in two locations in Bangladesh prove the efficacy of a water treatment device that delivers chlorine without electricity, in preventing diarrhoea A novel water treatment device that delivers chlorine automatically via public taps without the need for electricity, reduced child diarrhoea by 23% compared with controls (156 cases out of 2,073 child measurements [7.5%] vs 216/2,145 [10%]). This worked over 14 months in two urban neighbourhoods of Bangladesh, according to a randomised trial following more than 1,000 children published in The Lancet Global Health journal.Clean water is still a major problem in poor urban communities in low-income countries, where contamination by bacteria can lead to high rates of diarrhoeal diseases such as cholera and typhoid, harming children’s health and growth.Worldwide, an estimated one billion people who have access to piped water are drinking water that does not meet international safety standards.Most previous research has focused on household-level water treatment interventions that require people to calculate the correct dosage and add their own chlorine daily—but these have had low uptake and failed to reduce diarrhoea, partly because they deliver a chlorine dose that makes chlorinated water taste and smell unpleasant.In this study, the device used a low chlorine dose which increased taste acceptability and achieved high uptake while still improving drinking water quality. “Chlorination is one of the cheapest and most widely available methods to make drinking water safe, but poor taste and bad smell of chlorinated water are major barriers to adoption,” explains co-author Dr Sonia Sultana from icddr,b (International Centre for Diarrhoeal Diseases Research, Bangladesh). “Our findings indicate that automated chlorine dosing below the taste detection threshold has the potential to be transformative by ensuring high adoption rates and will hopefully help progress towards the global target of universal access to safe and affordable drinking water.” “Chlorination is one of the cheapest and most widely available methods to make drinking water safe, but poor taste and bad smell of chlorinated water are major barriers to adoption,” Although one of the first field trials of this new technology, the authors say that chlorinating water at the point-of-collection could be an effective, scalable strategy in low-income urban settings to reduce diarrhoeal diseases.More research will be needed to determine where this technology should be implemented to maximise health benefits, as the intervention was more effective in Bangladesh’s capital city Dhaka city than in Tongi on the outskirts of the city. “This novel, low-cost technology requires no behaviour change or effort by users—safe water comes straight out of the tap,” says Dr Amy Pickering from Tufts University, USA who led the research. “This point-of-collection approach to water treatment could be a transformative strategy for reducing gastrointestinal disease burden in low-income urban communities.We are now expanding the project to roadside water stands in Kenya, and working on a business model that could work in other countries.” In this study, researchers used a novel treatment device that automatically dispenses small amounts of chlorine to water from public taps and shared hand pumps.In the device, water flows past solid tablets of chlorine which dissolve into the water to treat it.Identical dispensers were installed at 100 shared water points in two low-income neighbourhoods in Bangladesh (Dhaka and Tongi) fed by piped water that is delivered intermittently, as is common in low-income settings.Water points were randomly assigned to have their drinking water automatically chlorinated (intervention) or to be treated with vitamin C (control group). Between July 2015 and November 2015, 920 households with at least one child under the age of 5 years were assigned to the chlorine treatment (50 water points; 517 children) or control groups (50 water points; 519 children). Because of high migration, children could transfer into or out of the shared water points.Every 2–3 months during the 14–month follow up period, caregiver-reported child diarrhoea (3 or more loose or watery stools in 24 hours) was measured alongside household and tap water quality (microbes, taste, smell), child weight, acute respiratory illness, and the presence of sufficient chlorine residual to prevent recontamination by dirty containers, utensils, or hands.Before the trial began, the authors identified the concentration of chlorine that would be below the taste detection threshold for most residents, ensuring participants would not know which study group they were in, and would not be put off by the taste of chlorine.Blinding was largely successful during the triial, with most participants unable to accurately guess which intervention they had received.Nevertheless, nine communal water points in the intervention group were uninstalled, primarily due to individual complaints about the smell and taste of chlorinated water.Chlorine residual was detected at the point of collection from shared taps 83% of the time in the treatment group compared to 0% of the time in the control group.E. coli contamination was detected in 15% of tap samples in the treatment group compared with 64% in the control group.Results showed that, over 14 months, children in the treatment group had substantially less diarrhoea than those in the control group (156 cases out of 2,073 child observations [7.5%] vs 216/2,145 [10%]). . The post Automatic device to deliver chlorine in public taps reduces child diarrhoea appeared first on Health news, Medibulletin .'

Your child must get vaccinated, here’s why

Parenting Healthshots

Vaccines help to prevent and protect from debilitating illnesses such as pneumonia, diarrhoea, whooping cough, measles, and polio.
'Delhi became the 24th state this week to make rotavirus vaccination against severe diarrhoea a part of the routine immunization programme. Three doses of five drops given at age 6 weeks, 10 weeks and 14 weeks protects children against severe diarrhoea, which leads to an estimated 80,000 deaths, 900,000 hospital admissions, and 32.7 lakh clinical every year. Vaccines have prevented 10 million deaths and protected millions more from debilitating illnesses such as pneumonia, diarrhoea, whooping cough, measles, and polio between 2010 and 2015, according to the World Health Organization (WHO), which called immunisation “one of the biggest successes of modern medicine”. But vaccine hesitancy, or the reluctance or refusal to vaccinate despite availability and affordability, is leading to a resurgence of vaccine-preventable diseases worldwide, which has prompted the WHO to list it as one of the top 10 threats to global health in 2019. Rumour has led to a spurt in polio cases in Pakistan, which has reported 53 cases to date this year compared to 12 in all of 2018. Polio vaccination led to a 99% drop in polio cases within three decades, with cases declining from 350,000 cases in 1988 to 33 in 2018. In 2019, vaccine hesitancy in Pakistan has led to 65 cases till August 7 in two endemic countries of Pakistan (53), and Afghanistan (12). To ensure outbreak in Pakistan does not threaten India’s polio-free status – the last polio cases were in West Bengal in January 13, 2011 – everyone crossing the land border with Pakistan, Nepal and Bangladesh is vaccinated, and a vaccination certificate irrespective of age at least four weeks before travel is a visa requirement for all international visitors to and from polio-affected Afghanistan, Nigeria, Pakistan, Ethiopia, Kenya, Somalia and Syria. Despite eradication, one national and two sub-national rounds of polio vaccination is continuing, along with surveillance for acute flaccid polio infection in children and environmental sampling for wild poliovirus in 51 sites. For every one polio case, there are 100-2,000 people are infected but don’t develop symptoms. Since the poliovirus multiplies in the gut, even asymptomatic infected people shed the virus in their faeces, which can be detected from testing sewage. India has the world’s largest immunisation programme that vaccinates an annual birth cohort of 26.7 million children against 12 vaccine-preventable diseases, of which 10 are given nationwide. Sub-national immunisation includes vaccination against Japanese Encephalitis in endemic areas, and the pneumococcal vaccine given in five states since 2017 to protect children against severe pneumonia and some ear infections. This has led to improvements in child health, indicated by a decline in under-5 mortality (U5-MR) rate from 43 in 2015 to 39 per 1,000 births in 2016. Around 98% of children are vaccinated at least once, of which 70% are fully immunised, 28% miss some vaccines, and 2% don’t get vaccinated at all. A deeper dive into data shows vaccination rates vary substantially by geography, gender, mother’s education and income, with U5-MR being 37 for boys and 41 for girls. Even in low-income areas and urban slums in Delhi, 78 girls were fully immunised for every 100 boys. Fake news is adding further hurdles to end measles-rubella using the MR vaccine, which is being given in 32 states and union territories with 95-96% coverage. The only states left are West Bengal and Delhi, where vaccination in schools was stopped following safety concerns that led to Delhi High Court ruling parental consent is a must to vaccinate children. Unlike viruses like influenza, Nipah, Zika and Ebola, humans are the only natural reservoirs of smallpox, polio and measles-rubella viruses, which makes it possible to eradicate and control them. The smallpox vaccine globally eradicated smallpox in 1979, which killed an estimated 300 million in the 20th century, compared to 100 million deaths in wars in the same period. Mass vaccination helped India get polio cases down from 741 in 2009 to one in January 2011. Eliminating a disease is possible by vaccinating at least 99% of children to build “herd immunity” in the community immunity that protects even those who are not vaccinated and remain susceptible to infection. As demonstrated by polio, the last mile is the biggest challenge in disease elimination, when vaccinated every child becomes imperative for controlling infection. With emotionally-charged fake news shared within minutes on social media, debunking rumours with facts has to be part of public health strategy to control disease and save lives'