Household water management: refining the dominant paradigm.

This paper questions the validity of the currently held paradigm that greater emphasis should be given to safe excreta disposal and the use of water for domestic and personal hygiene than to drinking water quality. It critically analyses aspects of the methodology of earlier studies such as the inclusion criteria, systematic review methods and statistical approach. The authors report on a brief analysis of 21 field trials dealing specifically with interventions to enhance household drinking water quality, which suggests a median reduction in diarrhoeal disease of 42%. The result was fairly consistent regardless of the nature of the intervention. Tropical Medicine and International Health 2004;9:187-91.