PLOS Water
Abstract
This randomized implementation trial tests in-line chlorination in piped drinking-water systems across 20 rural villages in Odisha, India, over one year. The study assesses whether chlorine-tablet systems can be installed and operated, whether households continue to use treated piped water, and whether treatment reduces fecal contamination, including antibiotic-resistant bacteria. Chlorine was detected in about half of tap-water samples during the study and more often after the target dose was raised. The intervention reduced E. coli in household tap and stored water and reduced the time people spent treating water manually, a task usually performed by women. Despite some complaints about taste and odor, households continued to rely on piped water. The results show that water-quality gains are possible, while consistent dosing, monitoring, and attention to user preferences remain important implementation needs.