Thursday, 2 April 2015

Sari to see you go: Reduction of cholera in Bangladeshi villages by simple filtration.


Cholera is a known waterborne disease which thrives in developing countries, the majority of cases go unnoticed, yet more severe cases can be fatal. The disease is caused by the bacteria Vibrio cholera. In less developed countries rivers and ponds are the primary source of drinking water for humans and animals, this water is consumed without any treatment to remove harmful bacteria. Due to financial restraints these countries possess poor sewerage management meaning contamination regularly occurs as a result of faecal matter finding its way into the water system. Additionally, during times of high marine and fresh water phytoplankton blooms there is a subsequent increase zooplankton numbers (including copepods). Sochard et al., (1979) found V.cholerae to be present in the guts of copepods, adding to bacterial transmission and an increase in cholera outbreaks.  

The study of Colwell et al., (2003) investigated the reduction of V.cholerae by filtration of water before consumption in a feat to remove any zooplankton which may carry the bacteria. Numerous villages in Bangladesh were employed to trial two different methods of filtration or a control of no filtration of their drinking water, a preliminary study using these methods was conducted before the full study was completed. The full study was conducted for a total of 18 months with each of the villages being assigned one particular treatment either filtration using a sari, filtration using a nylon filter or no filter (control). Standardised procedures were taught to the villagers on how to filter the water they gathered and how to store water appropriately. The nylon net filters provided for filtration were 150 µm mesh size and the sari’s were cotton and required folding 4-8 times to create the ideal filter.

Compliance of the villagers in maintaining the standardisation of the study was exemplary and assisted in the success of the study. Due to the small sample number used in preliminary experimentation, statistical significance was not obtained. However, due to the higher sample number in the full study there was a significantly lower number of cholera cases in the nylon and sari filtration groups compared to the control. Due to the size of the sari and nylon filters copepods and particulate matter were be removed from the water. Through analysis of the data it was deemed that there were around half the number of cholera cases when the sari was used in comparison to no filtration.  This led to the conclusion that cases of cholera were halved when copepods were removed from the water collected for domestic use. Through laboratory examination the sari was determined to remove all zooplankton, most phytoplankton and particulate matter greater than 20 µm, the nylon filter was found to be almost as effective.

As sari cloth is a common affordable material in Bangladesh and easily obtainable by the villagers, this adds to its suitability as a filter for untreated water. As similarly constructed material can be found worldwide at a relatively cheap cost, its use as a filter can be applied globally to reduce cases of cholera. These positive steps towards reducing the cholera causing V.cholerae show that there are still financially viable solutions to waterborne disease control. Applications of simple measures in the developing world which are cost effective could reduce ill health and reduce contamination.

Colwell, R.R., Huq, A., Siraul Islam, M., Aziz, K.M.A., Yunus,M., Huda Khan, N., Mahmuds, A., Sack, B.R., NAirre, G.B., Chakraborty,S., Sack, D.A. and Russek-Cohen, E. Reduction of cholera in Bangladeshi villages by simple filtration. (2003). PNAS. 100 (3) pp. 1051-1055.


References
Sochard, M.R., Wilson, D.F., Austin, B. and Colwell,R.R. (1979) Bacteria Associated with the Surface and Gut of Marine Copepods. Applied Environmental Microbiology. 37 (4) pp. 750-759.

2 comments:

  1. Hi Emma,

    Thanks for the post! It was good to here a bit more about this study, its really neat as the finding can empower local people without the need to wait for aid/government intervention. Do you know how widely this use of cloth was rolled out (no pun intended) across the region after this? Did the authors also speculate as to if this would filter out other pathogens and parasites? Presumably it would be effective against parasitic worms etc.

    Kind Regards

    ReplyDelete
  2. Hi Tom,

    I'm glad you enjoyed it, as you said it shows that education and participation of individuals can assist in the prevention of disease. The research group performed a follow up study on the use of cloth as a filtration device 5 yeas after the original study, this can be viewed through this link, it makes for interesting reading http://mbio.asm.org.plymouth.idm.oclc.org/content/1/1/e00034-10.full.pdf+html. Some villagers were seen to be continuing with the use of cloth as filters, although not all the villagers had continued using filtration there appears to be a reduction in the cases of cholera and its use may even have a positive effect on others in the area not suing filtration. As the saris were folded to remove objects of 150µm or more the majority of organisms of this size would be removed including any parasitic organisms of this size. It is great to see that such simple and affordable methods can assist in the continued prevention of cholera in vulnerable areas.

    Thanks
    Emma

    ReplyDelete

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