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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Systematic review: Assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: Systematic review and meta-regression
Tropical Medicine and International Health, Volume 19, No. 8, Year 2014
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Description
Objective: To assess the impact of inadequate water and sanitation on diarrhoeal disease in low- and middle-income settings. Methods: The search strategy used Cochrane Library, MEDLINE & PubMed, Global Health, Embase and BIOSIS supplemented by screening of reference lists from previously published systematic reviews, to identify studies reporting on interventions examining the effect of drinking water and sanitation improvements in low- and middle-income settings published between 1970 and May 2013. Studies including randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined were eligible. Risk of bias was assessed using a modified Ottawa-Newcastle scale. Study results were combined using meta-analysis and meta-regression to derive overall and intervention-specific risk estimates. Results: Of 6819 records identified for drinking water, 61 studies met the inclusion criteria, and of 12 515 records identified for sanitation, 11 studies were included. Overall, improvements in drinking water and sanitation were associated with decreased risks of diarrhoea. Specific improvements, such as the use of water filters, provision of high-quality piped water and sewer connections, were associated with greater reductions in diarrhoea compared with other interventions. Conclusions: The results show that inadequate water and sanitation are associated with considerable risks of diarrhoeal disease and that there are notable differences in illness reduction according to the type of improved water and sanitation implemented. © 2014 John Wiley & Sons Ltd The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.
Authors & Co-Authors
Wolf, Jennyfer
Unknown Affiliation
Prüss-Üstün, Annette M.
Unknown Affiliation
Cumming, Oliver
Unknown Affiliation
Bartram, Jamie K.
Unknown Affiliation
Bonjour, Sophie
Unknown Affiliation
Cairncross, Sandy
Unknown Affiliation
Clasen, Thomas F.
Unknown Affiliation
Colford, John Matthew
Unknown Affiliation
Curtis, Val A.
Unknown Affiliation
De France, Jennifer
Unknown Affiliation
Fewtrell, Lorna
Unknown Affiliation
Freeman, Matthew Charles
Unknown Affiliation
Gordon, Bruce A.
Unknown Affiliation
Hunter, Paul R.
Unknown Affiliation
Jeandron, Aurelie
Unknown Affiliation
Johnston, Richard Bart
Unknown Affiliation
Maeusezahl, Daniel
Unknown Affiliation
Mathers, Colin
Unknown Affiliation
Neira, Maria Purificacion
Unknown Affiliation
Higgins, Julian P.T.
Unknown Affiliation
Statistics
Citations: 430
Authors: 20
Affiliations: 14
Identifiers
Doi:
10.1111/tmi.12331
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Environmental
Infectious Diseases
Study Design
Randomised Control Trial
Case-Control Study
Study Approach
Systematic review