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Household Water Treatment and Cholera Control

Water,  sanitation,  and  hygiene  are  one  part  of  a  cholera  control  strategy.  Household  water  treatment  (HWT)  in  particular  has  been  shown  to  improve  the  microbiological  quality  of  stored  water  and  reduce  the  disease  burden.  We  conducted  a  systematic  review  of  published  and  gray  literature  to  determine  the  outcomes  and  impacts  of  HWT  in  preventing  cholera  specifically.  Fourteen  manuscripts  with  18  evaluations  of  HWT  interventions  in  cholera  were  identified.  Overall,  a  moderate  quality  of  evidence  suggests  that  HWT  interventions  reduce  the  burden  of  disease  in  cholera  outbreaks  and  the  risk  of  disease  transmission.  Appropriate  training  for  users  and  community  health  worker  follow-up  are  necessary  for  use.  Barriers  to  uptake  include  taste  and  odor  concerns,  and  facilitators  include  prior  exposure,  ease  of  use,  and  links  to  preexisting  development  programming.  Further  research  on  local  barriers  and  facilitators,  HWT  filters,  scaling  up  existing  development  programs,  program  sustainability,  integrating  HWT  and  oral  cholera  vaccine,  and  monitoring  in  low-access  emergencies  is  recommended.

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