Water, Sanitation, and Diarrheal Disease in the Slums of Brazil: A Comparison of Intervention Techniques

Background: Globally, 1.1 billion people lack access to safe drinking water. Diarrheal diseases due to poor water quality result in millions of deaths each year. Residents in the slums of Brazil are susceptible to diarrheal disease because they have limited access to safe drinking water and lack effective sanitation methods.

Objective: Assess the issues surrounding water, sanitation, and diarrheal diseases within urban slums of Brazil, evaluate several point-of-use water treatment techniques as implemented in other countries, and make a recommendation for a treatment program to reduce the burden of water-borne diarrheal disease in the urban slums of Brazil.

Methods: Reviewed a selection of published papers and data on point-of-use water treatment programs in Cambodia, Brazil, and Bolivia, including the successes and failures of these programs and the impacts on diarrheal disease within each study group. Evaluations of intervention techniques were based on: decreased disease rates, cost-effectiveness, cultural acceptance, accessibility, and sustainability.

Results: In Cambodia, a water and sanitation program including household ceramic filters for point-of-use and safe storage resulted in a 46% reduction of diarrheal diseases. In Bolivia, combined ceramic filter and education programs reduced diarrheal disease by 64%. A sanitation–only program in Brazil saw a mere 22% decrease in diarrhea prevalence. Studies show combined point-of-use treatment, education, and sanitation programs were most effective.

Conclusions: We recommend ceramic filters as a point-of-use intervention for our target population, in addition to sewage infrastructure and education efforts to change personal behavior and decrease prevalence of diarrheal diseases.