2012-04-17-世界卫生组织-Considerations_for_policy_development_and_scaling-up_household_water_treatment_and_safe_storage_with_communicable_disease_prevention_efforts_46页_651kb

This report analyzes the integration of Household Water Treatment and Safe Storage (HWTS) with health efforts and reviews the evidence regarding HWTS efficacy and scalability. Key points are:

1. HWTS Effectiveness

• Laboratory and controlled trials demonstrate that certain HWTS methods (boiling, chlorination, filtration) reduce microbial contamination and diarrheal disease.
• Evidence is strongest for boiling but weak for chlorination due to variability in chlorine use. Filtration shows promise with consistent use.
• Challenges include limited evidence for solar disinfection (SODIS) and insufficient evidence for other technologies like silver-impregnated filters.
• Evidence gaps persist in areas with poor sanitation and unimproved water sources.

2. Health Benefits

• Studies show HWTS reduces diarrheal disease morbidity and mortality, especially among vulnerable groups like young children, PLHIV, and emergency settings.
• Improved HWTS methods benefit PLHIV by reducing diarrheal incidence and may reduce disease progression.
• Economic gains are evident but not always demonstrated for HWTS compared to other interventions.

3. Discussion Conclusions

• The Task Force concluded HWTS may be effective, especially under optimal conditions including consistent implementation and appropriate context (e.g., use of effective technologies in settings with contamination).
• Challenges to HWTS scale-up include: not being sufficient alone without addressing other transmission pathways (e.g., sanitation); the need for correct and consistent use; behavioural sustainability; and variability in implementation.

4. Recommendations

• Promote HQTS technologies meeting WHO performance criteria.
• Support implementation research to improve uptake and sustain use.
• Scale up integration with key health programs, particularly for vulnerable groups.
• Establish clear HWTS targets and improve evidence through rigorous evaluations, including longer-term effectiveness studies.