Effectiveness of ceramic filtration for drinking water treatment in Cambodia Public Deposited

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  • March 19, 2019
Creator
  • Brown, Joseph
    • Affiliation: Gillings School of Global Public Health, Department of Environmental Sciences and Engineering
Abstract
  • For the estimated 66% of Cambodians without access to improved drinking water sources and the potentially much greater percentage without consistent access to microbiologically safe water, point-of-use water treatment coupled with appropriate storage to prevent recontamination is a promising option for securing access to safe drinking water. The ceramic water purifier (CWP) is an emerging point-of-use water treatment technology that is made locally in Cambodia and in several other developing countries based on a design originally developed in Latin America in the 1980s. Despite the filter's increasingly widespread promotion and implementation as a public health intervention within Cambodia and worldwide, its effectiveness in reducing waterborne microbes and diarrheal disease in users has not been adequately characterized. This dissertation examines: (i) the microbiological effectiveness of locally produced ceramic filters in Cambodia against bacterial and viral surrogates in the laboratory and in field use; (ii) the health impacts of the CWP and a modified CWP in a randomized, controlled trial in a rural/peri-urban village; and (iii) the continued use, microbiological effectiveness, and sustained health impacts of the CWP after up to 44 months in household use in three provinces of Cambodia. Results indicate filters as currently produced do reduce microbial indicators in drinking water and contribute to the reduction of diarrheal disease in users. Key findings were: (i) CWPs reduced E. coli up to 99.9999%, with mean reductions of approximately 99% in both laboratory and field testing; (ii) CWPs reduced MS2, a viral surrogate, by a mean 90-99% in laboratory testing; (iii) use of the CWP reduced diarrheal disease outcomes by approximately 40% in users versus non-users, after controlling for clustering within households and within individuals over time in a randomized, controlled trial; (iv) filters maintained effectiveness over long periods, up to 44 months in field use; (v) declining use of the CWPs after implementation was observed due to breakages of the ceramic filter elements coupled with limited availability of replacement parts in communities; and (vi) CWPs in field use were susceptible to recontamination through improper handling practices.
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  • In Copyright
Advisor
  • Sobsey, Mark
  • DiGiano, Francis A.
  • Weber, David
  • Loomis, Dana P.
  • Aitken, Michael
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2008
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