Solar disinfection of drinking water protects against cholera in children under 6 years of age

Background and Aims-We have previously reported a reduction in risk of diar rhoeal disease in children who used solar disinfected drinking water. A cho lera epidemic, occurring in an area of Kenya in which a controlled trial of solar disinfection and diarrhoeal disease in children aged under 6 had rec ently finished, offered an opportunity to examine the protection offered by solar disinfection against cholera. Methods-In the original trial, all children aged under 6 in a Maasai commun ity were randomised by household: in the solar disinfection arm, children d rank water disinfected by leaving it on the roof in a clear plastic bottle, while controls drank water kept indoors. We revisited all households which had participated in the original trial. Results-There were 131 households in the trial area, of which 67 had been r andomised to solar disinfection (a further 19 households had migrated as a result of severe drought). There was no significant difference in the risk of cholera in adults or in older children in households randomised to solar disinfection; however, there were only three cases of cholera in the 155 c hildren aged under 6 years drinking solar disinfected water compared with 2 0 of 144 controls. Conclusions-Results confirm the usefulness of solar disinfection in reducin g risk of water borne disease in children. Point of consumption solar disin fection can be done with minimal resources, which are readily available, an d may be an important first line response to cholera outbreaks. Its potenti al in chorine resistant cholera merits further investigation.