Clinical and Microbiologic Efficacy of a Water Filter Program in a Rural Honduran Community

Water purification in rural Honduras is at the heart of the non-profit organization Honduras Outreach Medical Brigade Relief Effort (HOMBRE). We evaluated the use of the water filter and tested the microbiological and clinical effectiveness of the filter. A 22-item questionnaire assessed water sources, procurement / storage, purification and the incidence of gastrointestinal disease.

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Samples were obtained from clay-based household filters in La Hicaca and associated with investigations from the same house. We counted bacterial colonies of four bacterial classifications from each sample. Sixty-five surveys have been completed. Forty-five (69%) individuals used a filter. Fifteen respondents reported diarrhea in their home in the past 30 days; this incidence was higher in homes that did not use a filter. Thirty-three paired water samples and surveys were available. Twenty-eight samples (85%) demonstrated bacterial growth. A control sample was obtained from the local river, the main source of water; number and types of bacterial colony were innumerable within 24 hours. Access to clean water, the use of filters, and other treatment methods differed within a geographically proximal region. Although most water samples have failed to achieve bacterial eradication, water filters can sufficiently reduce bacterial coliform counts to levels below infectious inoculation. Clay water filters can be sustainable water treatment measures in resource-poor environments.

1. Introduction
Worldwide, over 1 billion people do not have access to better sources of drinking water. Lack of clean water contributes significantly to water-related diseases, especially in developing countries [1].

Many communities in Honduras lack access to clean water. This is especially true in rural areas; approximately ninety-nine percent of the country’s urban population has access to better water than eighty-two percent of the country’s rural population [2]. Up to ninety percent of rural water supply in Honduras comes from intermittent or unreliable sources [3] and water purification efforts reach sixty percent of the country’s total population, but only fifty percent of rural communities in the country. country [3].

Worldwide, diarrhea is a leading cause of mortality in children under the age of five. The availability of clean water has previously been associated with lower mortality and a lower risk of childhood diarrhea [4]. Lack of clean water in rural Honduran communities translates into great potential for the development of waterborne disease and potential death in infants and young children. Diarrhea accounted for seven percent of deaths in children under five in Honduras in 2010 [5]. There is a discrepancy in the infant mortality rate in children under the age of five between the urban communities of Honduras (twenty-nine percent) and rural Honduras (forty-three percent) [5] and may be partly consistent with differences in access to drinking water as well as other differences between the two communities.

Point-of-use (POU) technologies are interventions that provide clean water to homes where public water treatment is not available. Clay household water filters are a POU mechanism with the potential to reduce diarrheal disease. Starting in the late 1980s and early 1990s, ceramic filters began to appear in poor communities in developing countries as a means of providing clean drinking water [6]. These devices reduce the levels of turbidity and bacteria in the water by ninety-nine percent [7]. The water flows through the filter, impregnated with colloidal silver, at a flow rate of one to two liters per hour. As water flows through the clay pores, bacteria and other turbidities are trapped and the antimicrobial properties of silver prevent the growth and replication of bacteria [8]. Previous field studies have shown a decrease in the risk and incidence of gastrointestinal disease following the implementation of the use of the water filter, although further tests were needed for conclusive results [9].

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