Robert M Hoekstra

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In an earlier study in rural Guatemala, 257 households that received flocculant-disinfectant to treat their drinking water had 39% less diarrhea than 257 control households. Three weeks after completion of the study, national marketing of the flocculant-disinfectant was extended into the study communities. Six months later, we assessed frequency of and(More)
OBJECTIVE Human Salmonella infections associated with dry pet food have not been previously reported. We investigated such an outbreak of Salmonella Schwarzengrund and primarily affecting young children. PATIENTS AND METHODS Two multistate case-control studies were conducted to determine the source and mode of infections among case-patients with the(More)
The December 2004 tsunami in Sumatra, Indonesia, destroyed drinking water infrastructure, placing over 500,000 displaced persons at increased risk of waterborne disease. In June 2005, we assessed the relationship of water handling behaviors to household water quality in three districts: Aceh Besar, Simeulue, and Nias. We surveyed 1,127 households from 21(More)
OBJECTIVE To evaluate associations between handwashing promotion and child growth and development. DESIGN Cluster randomized controlled trial. SETTING Informal settlements in Karachi, Pakistan. PARTICIPANTS A total of 461 children who were enrolled in a trial of household-level handwashing promotion in 2003 and were younger than 8 years at(More)
Populations living in informal settlements with inadequate water and sanitation infrastructure are at risk of epidemic disease. In 2010, we conducted 398 household surveys in two informal settlements in Nairobi, Kenya with isolated cholera cases. We tested source and household water for free chlorine residual (FCR) and Escherichia coli in approximately 200(More)
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