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Safe Water System (SWS) - Where Has the SWS Been Used?
- Bolivia
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| Safe Water Home
> Where?
> Bolivia
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Project Partners
 CDC
Child and Community Health Project/PROSIN
USAID
PSI
Andean Rural Health Care
Rotary Club of Estes Park, Colorado
PAHO
Millipore Foundation
Project Concern International
Centro Nacional de Enfermedades Tropicos
Ministry of Public Health
Peace Corps
Instituto Bibosi
Local municipalities
Pro Habitat
Universidad Mayor de San Andres
Ministerio de Urbanismo y Vivienda
Target Populations/Location
 First
field trial: periurban population in El Alto, Bolivia
Second field trial: street vendors in La Paz, Bolivia
Third field trial: periurban population in Montero,
Bolivia
Social marketing trial: urban and rural populations
in Santiesteban, Ichilo, and Sara Provinces in northern
Santa Cruz Department
Expansion: 7 departments (states) of Bolivia
Project Design
- Three successive field trials to test impact of
the SWS on water quality, diarrhea, and street-vended
beverages
Trial of social marketing
Large-scale implementation project
Intervention Elements
- Sodium hypochlorite solution produced locally
using appropriate technology, with the brand name
CLARO
Locally produced, 20-liter plastic containers with
spigots
Community education
Social marketing
Project Start Date
- Field trial one: December 1992
Field trial two: June 1993
Field trial three: September 1994
Social marketing (CLARO) trial: November 1996
Social marketing expansion project: March 1997
Results of Project Evaluations
- In the El Alto field trial, narrow-mouth, plastic
water storage vessels and 5% calcium hypochlorite
solution for home disinfection of stored water were
provided to a Bolivian Aymara Indian community at
risk for cholera. Each of 42 families in the study
obtained water from a household well; fecal coliform
bacteria were found in water from 40/42 (95%) wells
(geometric mean 84.7 colonies/100 ml) and 34/42
(81%) usual water storage vessels (geometric mean
57.6 colonies/100 ml). One group of families received
the special vessels and chlorine (group A), a second
received only the special vessels (group B), and
a third served as a control
 group
(group C). Water samples collected every 3 weeks
from group A special vessels had lower geometric
mean fecal coliform colony counts (p <.0001)
and lower geometric mean Escherichia coli
colony counts (p <.0001) than water from group
B or C vessels. Adequate levels of free chlorine
persisted in these vessels for at least 5 hours.
The special vessels and chlorine solution were well
accepted and continued to be used for at least 6
months. Use of the vessel and chlorine solution
produced drinking water from nonpotable sources
that met WHO standards for microbiologic quality.
In the Montero field trial, 127 households in two
periurban communities were randomized into intervention
and control groups, surveyed, and the intervention
was distributed. Monthly water quality testing and
weekly diarrhea surveillance were conducted. Over
a 5-month period, intervention households had 44%
fewer diarrhea episodes than control households
(p=0.002). Infants <1 year old (p=0.05) and children
5-14 years old (p=0.01) in intervention households
had significantly less diarrhoea than control children.
Campylobacter was less commonly isolated
from intervention than controls (p=0.02). Stored
water in intervention participants households was
less contaminated with E. coli than stored
water in control households (p<0.0001). Intervention
households exhibited less E. coli contamination
of stored water and less diarrhea than control households.
An evaluation of the social marketing trial compared
an intervention group of households using CLARO
water vessels and disinfectant solution with a control
group of households using traditional water treatment
and storage methods. Three months after the launch
of the CLARO social marketing campaign, in the intervention
communities 50% of households reported using the
CLARO water vessel, 34 per cent said that they were
using CLARO disinfectant, but only 19% had detectable
levels of chlorine in their stored water.
Within intervention communities, households that
reported using the CLARO vessel or CLARO disinfectant
had significantly lower fecal coliform counts than
households
that reported not using these products (p<0.05).
During the 9-week prelaunch period, children <15
years old in intervention families had 0.22 episodes
of diarrhea per person, and in control families had
0.28 episodes per person. During the 12-week post-launch
period, children in intervention families had 0.12
episodes person, a reduction of 54.5 per cent, and
children in control families had 0.28 episodes per
person. The slope of the curve describing the weekly
incidence of diarrhea in families in intervention
communities showed a rate of decrease of disease that
was significantly greater than in control families
(p<0.05).
Remarks
- This project has scaled back because of funding
and management problems.
- CLARO water vessels and disinfectant have been
used by PAHO and various NGOs to respond to a series
of local, regional, and national emergencies, including
flooding associated with El Nino, earthquakes, landslides,
and cholera epidemics.
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Date:
August 24, 2005
Content source: National Center for Infectious Diseases
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PDF 308KB
