Water filters reduce diarrhoea among people with HIV

Water filter provision and home-based filter reinforcement reduce diarrhea in Kenyan HIV-infected adults and their household members.

Pavlinac PB, Naulikha JM, Chaba L, Kimani N, Sangare LR, Yuhas K, Singa BO, John-Stewart G, Walson JL. Am J Trop Med Hyg. 2014 Aug 6;91(2):273-80. doi: 10.4269/ajtmh.13-0552. Epub 2014 May 19.

Among human immunodeficiency virus (HIV)-infected adults and children in Africa, diarrheal disease remains a major cause of morbidity and mortality. We evaluated the effectiveness of provision and home-based reinforcement of a point-of-use water filtration device to reduce diarrhea among 361 HIV-infected adults in western Kenya by comparing prevalence of self-reported diarrhea before and after these interventions. After provision of the filter, 8.7% of participants reported diarrhea compared with 17.2% in the 3 months before filter provision (odds ratio [OR] = 0.39, 95% confidence interval [95% CI] = 0.23-0.66, P < 0.001). The association was similar among 231 participants who were already taking daily cotrimoxazole prophylaxis before being given a filter (OR = 0.47, 95% CI = 0.25-0.88, P = 0.019). Educational reinforcement was also associated with a modest reduction in self-reported diarrhea (OR = 0.50, 95% CI = 0.20-0.99, P = 0.047). Provision and reinforcement of water filters may confer significant benefit in reducing diarrhea among HIV-infected persons, even when cotrimoxazole prophylaxis is already being used.

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Editor’s notes: Diarrhoeal disease remains an important cause of morbidity among HIV-positive people. This analysis was part of a larger study of HIV-positive adults who were not taking antiretroviral therapy. The frequency of diarrhoea, measured by self-report, was compared before and after participants were given a water filtration device. After receiving the device, fewer people reported diarrhoea, with an odds ratio of 0.39. The beneficial effect was similar among people who were already taking cotrimoxazole prophylaxis. The benefits of water filtration or chlorination have been shown in previous studies, but this is a useful reminder of the value of clean water programmes in reducing diarrhoeal disease.  

Avoid TB deaths
Comorbidity
Africa
Kenya
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