First study of household water treatment to show a significant reduction in mortality

The current issue of the British Medical Journal online includes a scientific study conducted by the U.S. Centers for Disease Control and Prevention (CDC) that shows that household water treatment with PUR Purifier of Water developed by Procter & Gamble significantly lowers diarrhea in children. This is the first study of household water treatment to show a significant reduction in mortality.

"Worldwide, many people drink contaminated water," says John Crump, first author on the study and CDC Medical Epidemiologist. "Our study shows that among people who have highly contaminated and dirty drinking water, PUR can provide water that looks cleaner and reduces the risk of diarrhea, particularly among infants and children."

The study was a 20-week randomized, controlled health intervention trial conducted with 6,650 people living in rural western Kenya, near Lake Victoria, where families collect drinking water from shallow ponds and streams. Family groups were randomized to one of three groups: 1) continue traditional water handling practices, typically cloth filtration to remove turbidity, 2) receive dilute bleach, sodium hypochlorite, to disinfect their water or 3) receive PUR Purifier of Water, a small sachet that is added to contaminated water and removes turbidity as well as disinfects the water. Field workers visited households weekly and used a standardized questionnaire to record the presence or absence of diarrhea and any deaths during the seven days since the last visit.

This is the first study of household based water treatment to show a significant reduction in mortality. 28 deaths occurred in the control, 17 in the bleach, and 14 in the PUR group. There were significantly fewer deaths in the bleach and PUR groups combined compared with control compounds (relative risk of death 0.58, p=0.036) Because the study was not designed to evaluate an effect on mortality and a significant reduction in mortality was observed only when comparing both interventions compared to control practices, further research is needed to better understand the relationship between household based water treatments and reduction in mortality.

Because PUR was highly acceptable to consumers in this study, P&G has worked with a local women's group, the Society for Woman and AIDS in Kenya (SWAK) in order to continue to provide PUR to local consumers. P&G provides the product at cost and SWAK sells PUR for local income generation. P&G has also provided funding so that the non-profit group Population Services International (www.psi.org) can distribute PUR throughout Kenya."

Scientific reference to the study: John A Crump, Peter O Otieno, Laurence Slutsker, Bruce H Keswick, Daniel H Rosen, R Michael Hoekstra, John M Vulule, Stephen P Luby. Household based treatment of drinking water with flocculant- disinfectant for prevention of diarrhoea in areas with turbid source water in rural western Kenya: cluster randomized controlled trial, BMJ, doi:10.1136/bmj.38512.618681.E0 (published 26 July 2005).