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      Effect of Groundwater Iron on Residual Chlorine in Water Treated with Sodium Dichloroisocyanurate Tablets in Rural Bangladesh

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          Abstract.

          We assessed the ability of sodium dichloroisocyanurate (NaDCC) to provide adequate chlorine residual when used to treat groundwater with variable iron concentration. We randomly selected 654 tube wells from nine subdistricts in central Bangladesh to measure groundwater iron concentration and corresponding residual-free chlorine after treating 10 L of groundwater with a 33-mg-NaDCC tablet. We assessed geographical variations of iron concentration using the Kruskal–Wallis test and examined the relationships between the iron concentrations and chlorine residual by quantile regression. We also assessed whether user-reported iron taste in water and staining of storage vessels can capture the presence of iron greater than 3 mg/L (the World Health Organization threshold). The median iron concentration among measured wells was 0.91 (interquartile range [IQR]: 0.36–2.01) mg/L and free residual chlorine was 1.3 (IQR: 0.6–1.7) mg/L. The groundwater iron content varied even within small geographical regions. The median free residual chlorine decreased by 0.29 mg/L (95% confidence interval: 0.27, 0.33, P < 0.001) for every 1 mg/L increase in iron concentration. Owner-reported iron staining of the storage vessel had a sensitivity of 92%, specificity of 75%, positive predictive value of 41%, and negative predictive value of 98% for detecting > 3 mg/L iron in water. Similar findings were observed for user-reported iron taste in water. Our findings reconfirm that chlorination of groundwater that contains iron may result in low-level or no residual. User reports of no iron taste or no staining of storage containers can be used to identify low-iron tube wells suitable for chlorination. Furthermore, research is needed to develop a color-graded visual scale for iron staining that corresponds to different iron concentrations in water.

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          Point of use household drinking water filtration: A practical, effective solution for providing sustained access to safe drinking water in the developing world.

          The lack of safe water creates a tremendous burden of diarrheal disease and other debilitating, life-threatening illnesses for people in the developing world. Point-of-use (POU) water treatment technology has emerged as an approach that empowers people and communities without access to safe water to improve water quality by treating it in the home. Several POU technologies are available, but, except for boiling, none have achieved sustained, large-scale use. Sustained use is essential if household water treatment technology (HWT) is to provide continued protection, but it is difficult to achieve. The most effective, widely promoted and used POU HWTs are critically examined according to specified criteria for performance and sustainability. Ceramic and biosand household water filters are identified as most effective according to the evaluation criteria applied and as having the greatest potential to become widely used and sustainable for improving household water quality to reduce waterborne disease and death.
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            Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis.

            We conducted a systematic review of all studies that measured diarrheal health impacts in children and the impact on water quality of point-of-use chlorine drinking water treatment. Twenty-one relevant studies were identified from > 856 screened abstracts. Data were extracted and combined using meta-analysis to provide summary estimates of the intervention effect. The intervention reduced the risk of child diarrhea (pooled relative risk: 0.71, 0.58-0.87) and it reduced the risk of stored water contamination with Escherichia coli (pooled relative risk: 0.20, 0.13-0.30). A major finding from this review is that nearly all trials on this topic have been short (median length was 30 weeks). Although not statistically significant, we observed an attenuation of the intervention's reduction of child diarrhea in longer trials. Future studies with multi-year follow-up are required to assess the long-term acceptability and sustainability of health impacts shown by the shorter trials identified in this review.
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              Geochemical study of arsenic release mechanisms in the Bengal Basin groundwater

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                Author and article information

                Journal
                Am J Trop Med Hyg
                Am. J. Trop. Med. Hyg
                tpmd
                tropmed
                The American Journal of Tropical Medicine and Hygiene
                The American Society of Tropical Medicine and Hygiene
                0002-9637
                1476-1645
                April 2018
                12 February 2018
                12 February 2018
                : 98
                : 4
                : 977-983
                Affiliations
                [1 ]International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;
                [2 ]Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia;
                [3 ]Division of Epidemiology, School of Public Health, University of California, Berkeley, California;
                [4 ]Stanford Woods Institute for the Environment and Freeman Spogli Institute for International Studies, Stanford University, Stanford, California
                Author notes
                [* ]Address correspondence to Abu Mohd. Naser, Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, 2nd floor, CNR Building, Room #2030E, Atlanta, GA 30322. E-mail: atitu@ 123456emory.edu

                Financial support: This research was funded by the Bill and Melinda Gates Foundation, Global Health Grant Number OPPGD759. Medentech donated the NaDCC but was not involved in design, analysis, and publication decision of the study.

                Authors’ addresses: Abu Mohd. Naser, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh, and Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, E-mail: abu.mohd.naser.titu@ 123456emory.edu . Eilidh M. Higgins, Department of Environmental Health Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, E-mail: eilidh.higgins@ 123456gmail.com . Shaila Arman, Sania Ashraf, Kishor K. Das, Mahbubur Rahman, and Leanne Unicomb, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh, E-mails: shailaarman@ 123456gmail.com , sashraf2@ 123456jhu.edu , kishorisrt@ 123456gmail.com , mahbubr@ 123456icddrb.org , and leanne@ 123456icddrb.org . Ayse Ercumen, Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, E-mail: aercumen@ 123456berkeley.edu . Stephen P. Luby, Stanford Woods Institute for the Environment and Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, E-mail: sluby@ 123456stanford.edu .

                Article
                tpmd160954
                10.4269/ajtmh.16-0954
                5928807
                29436334
                a53e0a5b-3698-4ba5-ac21-7ed10ec775ba
                © The American Society of Tropical Medicine and Hygiene

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 06 December 2016
                : 20 December 2017
                Page count
                Pages: 7
                Categories
                Articles

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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