Water System Abstracts
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.
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.
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.