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*Prof. Dr. Dhrubo Jyoti Sen


Household water treatment using sodium hypochlorite (NaOCl) has been recognized as a cost‒effective means of reducing the heavy burden of diarrhoea and other waterborne diseases, especially among populations without access to improved water supplies. Sodium dichloroisocyanurate (NaDCC), which is widely used in emergencies, is an alternative source of chlorine that may present certain advantages over NaOCl for household‒based interventions in development settings. Like other sources of hypochlorous acid, NaDCC has been shown to be an effective antimicrobial agent. The chemical composition and physical characteristics of NaDCC tablets, however, may offer certain advantages over NaOCl as a possible donor of free chlorine in the disinfection of water at the household level. The safety of the compound for the routine treatment of drinking water has now been satisfactorily addressed. There is also evidence that suggests that use of NaDCC tablets increases compliance and is more acceptable and affordable than NaOCl thus potentially increasing overall uptake in a household‒based water treatment intervention. These advantages would have to be balanced against its relative lack of availability compared to NaOCl and the issues that this raises about its sustainability. While there is reason to believe that NaDCC may present a promising alternative to NaOCl in household based water treatment interventions, it has yet to be subjected to the same kinds of rigorous trials to which NaOCl and certain other point‒of‒use interventions have been subject. Longer‒term randomized, controlled trials in different settings in which NaDCC is compared not only against a control group without access to water treatment but also directly against an intervention group using NaOCl would help clarify its potential benefits, including microbiological effectiveness, compliance, acceptability and affordability. Some of these questions can also be explored in the assessment of pilot programs. Investigators should also determine the programmatic support necessary to achieve a given level of coverage in order to assess its cost‒effectiveness. This research would not only address remaining issues about the possible role of NaDCC tablets as a public health intervention, but also provide useful information to determine if investment that would be necessary to bring the intervention to scale on a sustainable basis would be warranted.

Keywords: Chlorine, Household, NaDCC, Sodium hypochlorite, Sodium dichloroisocyanurate, Water treatment.

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