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Is Drinking Water in Abidjan, C�te D'Ivoire Safe for Infant Formula?

Dunne E, Angoran Y, Kamelan-Tano K, Toussaint S, Monga B, Kouadiou L, Roels T, Wiktor S, Lackritz E, Mintz E, Luby S.

Background: In Africa, as many as 15% of children born to HIV-infected mothers may be postnatally infected with HIV through breast milk. HIV transmission through breast feeding may not be prevented by effective prenatal and antenatal antiretroviral therapy. Recommendations for mothers to reduce the risk of HIV transmission by formula feeding may lead to increased infant mortality if formula is prepared from contaminated water. We determined water quality and water storage practices for households in neighborhoods served by a
Projet RETRO-CI HIV maternal health clinic in Abidjan, Côte d'Ivoire.
Methods: We randomly selected 20 patients who attended the clinic and included their neighborhoods in the study. Within each neighborhood we randomly selected six households with at least one child £3 years of age. In each household, we administered a questionnaire to the caretaker and collected source and stored drinking water samples for microbiological testing.
Results: Eighty-nine (74%) of 120 caretakers gave the youngest child stored water for drinking. Stored water had lower levels of chlorine than source water (median 0.05 vs 0.2 mg/dl, p<.001). Escherichia coli was detected in 36 (41%) of 87 stored water samples and 1(1%) of 108 source water samples (odds ratio 76, 95% confidence interval 10.6-1522, p<.0001).
Conclusions: In Abidjan, drinking water for children is often stored and is commonly contaminated with E. coli, a marker of fecal contamination. Formula prepared from this stored water would be a likely vehicle for enteric infections. Household use of a safe water storage vessel and disinfectant could improve drinking water quality for all household members, and may especially benefit infants that are formula fed for prevention of postnatal HIV infection.

Suggested citation:

Dunne E, Angoran Y, Kamelan-Tano K, Toussaint S, Monga B, Kouadiou L, Roels T, Wiktor S, Lackritz E, Mintz E, Luby S. Is Drinking Water in Abidjan, C�te D'Ivoire Safe for Infant Formula? 49th annual EIS conference. April, 2000.


  

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