Impact of drinking water, sanitation and handwashing with soap on childhood diarrhoeal disease: updated meta-analysis and meta-regression
Jennyfer Wolf,Paul R. Hunter,Paul R. Hunter,Matthew C. Freeman,Oliver Cumming,Thomas Clasen,James K Bartram,Julian P T Higgins,Richard B. Johnston,Kate Medlicott,Sophie Boisson,Annette Prüss-Ustün +11 more
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TLDR
The main objective was an updated assessment of the impact of unsafe water, sanitation and hygiene (WaSH) on childhood diarrhoeal disease.Abstract:
OBJECTIVES: Safe drinking water, sanitation and hygiene are protective against diarrhoeal disease; a leading cause of child mortality. The main objective was an updated assessment of the impact of unsafe water, sanitation and hygiene (WaSH) on childhood diarrhoeal disease. METHODS: We undertook a systematic review of articles published between 1970 and February 2016. Study results were combined and analysed using meta-analysis and meta-regression. RESULTS: A total of 135 studies met the inclusion criteria. Several water, sanitation and hygiene interventions were associated with lower risk of diarrhoeal morbidity. Point-of-use filter interventions with safe storage reduced diarrhoea risk by 61% (RR = 0.39; 95% CI: 0.32, 0.48); piped water to premises of higher quality and continuous availability by 75% and 36% (RR = 0.25 (0.09, 0.67) and 0.64 (0.42, 0.98)), respectively compared to a baseline of unimproved drinking water; sanitation interventions by 25% (RR = 0.75 (0.63, 0.88)) with evidence for greater reductions when high sanitation coverage is reached; and interventions promoting handwashing with soap by 30% (RR = 0.70 (0.64, 0.77)) vs. no intervention. Results of the analysis of sanitation and hygiene interventions are sensitive to certain differences in study methods and conditions. Correcting for non-blinding would reduce the associations with diarrhoea to some extent. CONCLUSIONS: Although evidence is limited, results suggest that household connections of water supply and higher levels of community coverage for sanitation appear particularly impactful which is in line with targets of the Sustainable Development Goals.read more
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Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: An updated analysis with a focus on low- and middle-income countries.
Annette Prüss-Ustün,Jennyfer Wolf,Jamie Bartram,Thomas Clasen,Oliver Cumming,Matthew C. Freeman,Bruce Gordon,Paul R. Hunter,Paul R. Hunter,Kate Medlicott,Richard B. Johnston +10 more
TL;DR: Despite recent declines in attributable mortality, inadequate WASH remains an important determinant of global disease burden, especially among young children, and contributes to global monitoring such as for the Sustainable Development Goal indicator on mortality from inadequate Wash.
Journal ArticleDOI
The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement
Oliver Cumming,Benjamin F. Arnold,Radu Ban,Thomas Clasen,Joanna Esteves Mills,Matthew C. Freeman,Bruce Gordon,Raymond Guiteras,Guy Howard,Paul R. Hunter,Richard B. Johnston,Amy J. Pickering,Andrew J. Prendergast,Annette Prüss-Ustün,Jan Willem Rosenboom,Dean Spears,Shelly Sundberg,Jennyfer Wolf,Clair Null,Stephen P. Luby,Jean H. Humphrey,John M. Colford +21 more
TL;DR: The view is that these three new trials do not show that WASH in general cannot influence child linear growth, but they do demonstrate that these specific interventions had no influence in settings where stunting remains an important public health challenge.
Journal ArticleDOI
Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries.
TL;DR: The objective was to estimate global access to handwashing with soap and water to inform use of handwashing in the prevention of COVID-19 transmission, and disparities in handwashing access should be incorporated into CO VID-19 forecasting models when applied to low-income countries.
Journal ArticleDOI
The determinants of handwashing behaviour in domestic settings: An integrative systematic review.
TL;DR: It is found that there are limitations in the way behavioural determinant are conceptualised and measured and that research is biased towards exploring a narrow range of behavioural determinants.
Journal ArticleDOI
Childhood diarrhoeal diseases in developing countries.
TL;DR: An overview of the recent trends in the epidemiology and treatment of diarrhoea is given and the potentials of metagenomics technique as a diagnostic method for enteric infections are highlighted.
References
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