{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:38:45Z","timestamp":1792402725425,"version":"4.4.0"},"reference-count":26,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,12,6]]},"abstract":"<jats:p>Microbiological water quality is usually assessed by the identification of <jats:italic>Escherichia coli<\/jats:italic> (<jats:italic>E. coli<\/jats:italic>), a fecal indicator. The hydrogen sulfide (H<jats:sub>2<\/jats:sub>S) test is an inexpensive, easy-to-use, and portable alternative field-based water quality test. Our study evaluated the H<jats:sub>2<\/jats:sub>S test\u2019s effectiveness as a water quality indicator for diarrhea risk. Field workers collected stored drinking water samples for H<jats:sub>2<\/jats:sub>S analysis and detection of <jats:italic>E. coli<\/jats:italic> by membrane filtration and measured caregiver-reported diarrhea among children &lt; 5 years in the same households 1 month later. We assessed the association between the H<jats:sub>2<\/jats:sub>S test (incubated for 24 hours and 48 hours) and diarrhea prevalence, with 2-day and 7-day symptom recall periods (<jats:italic>N<\/jats:italic> = 1,348). We determined the sensitivity, specificity, and positive and negative predictive value (PPV, NPV) of the H<jats:sub>2<\/jats:sub>S test compared with <jats:italic>E. coli<\/jats:italic> (<jats:italic>N<\/jats:italic> = 525). Controlling for potentially confounding covariates, H<jats:sub>2<\/jats:sub>S-positive water (at 24 or 48 hours) was not associated with 2-day diarrhea prevalence (24-hour prevalence ratio [PR] = 1.03, 95% confidence interval [CI]: 0.63\u20131.69; 48-hour PR = 0.89, 95% CI: 0.58\u20131.38) or 7-day diarrhea prevalence (24-hour PR = 1.17, 95% CI: 0.76\u20131.78; 48-hour PR = 1.21, 95% CI: 0.81\u20131.80). The sensitivity, PPV, and NPV of the H<jats:sub>2<\/jats:sub>S test was significantly higher when the H<jats:sub>2<\/jats:sub>S test was incubated for 48 versus 24 hours whereas specificity showed the opposite trend. H<jats:sub>2<\/jats:sub>S test sensitivity, PPV, and NPV increased with increasing <jats:italic>E. coli<\/jats:italic> levels, consistent with previous evidence that the H<jats:sub>2<\/jats:sub>S test is a useful water quality tool in high-contamination settings. However, our results suggest that the H<jats:sub>2<\/jats:sub>S test is not an effective indicator for waterborne diarrhea.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0387","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T07:00:41Z","timestamp":1508223641000},"page":"1867-1871","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of the Hydrogen Sulfide Test as a Water Quality Indicator for Diarrhea Risk in Rural Bangladesh"],"prefix":"10.4269","volume":"97","author":[{"given":"Mahfuza","family":"Islam","sequence":"first","affiliation":[{"name":"Environmental Intervention Unit, Enteric and Respiratory Infections Program, Infectious Disease Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b);"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse","family":"Ercumen","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, School of Public Health, University of California, Berkeley, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu Mohd","family":"Naser","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences. Rollins School of Public Health, Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Unicomb","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit, Enteric and Respiratory Infections Program, Infectious Disease Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b);"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahbubur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit, Enteric and Respiratory Infections Program, Infectious Disease Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b);"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin F.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, School of Public Health, University of California, Berkeley, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Colford, Jr.","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, School of Public Health, University of California, Berkeley, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P.","family":"Luby","sequence":"additional","affiliation":[{"name":"Woods Institute for the Environment, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","author":"WHO","year":"2011"},{"key":"b2","author":"WHO","year":"2003"},{"key":"b3","series-title":"Am J Trop Med Hyg","first-page":"354","article-title":"Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and 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