ArticleThe American journal of tropical medicine and hygiene2014
Impact of rainfall on diarrheal disease risk associated with unimproved water and sanitation.
Article in The American journal of tropical medicine and hygiene, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- The global burden of climate-sensitive health impacts: a systematic review of mortality, morbidity, and economic costs.The Pan African medical journal · 2026Pooled it
- Rainfall and Temperature Influences on Childhood Diarrhea and the Effect Modification Role of Water and Sanitation Conditions: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2024Pooled it
- Understanding the Impact of Rainfall on Diarrhea: Testing the Concentration-Dilution Hypothesis Using a Systematic Review and Meta-Analysis.Environmental health perspectives · 2020Pooled it
- Does Basic Sanitation Prevent Diarrhea? Contextualizing Recent Intervention Trials through a Historical Lens.International journal of environmental research and public health · 2019Pooled it
- Influence of Temperature and Precipitation on the Effectiveness of Water, Sanitation, and Handwashing Interventions against Childhood Diarrheal Disease in Rural Bangladesh: A Reanalysis of the WASH Benefits Bangladesh Trial.Environmental health perspectives · 2024Trial
- Effectiveness of SMS messaging for diarrhoea measurement: a factorial cross-over randomised controlled trial.BMC medical research methodology · 2020Trial
- Child exposure to animal feces and zoonotic pathogens in northwest Ecuador: A mixed-methods study.PLoS neglected tropical diseases · 2026Article
- Safely managed drinking water service use and child diarrhoea based on evidence from 24 countries.Nature water · 2026Article
- Seasonal trends and short-term association between meteorological factors and diarrheal diseases among children under five in Tanzania.PloS one · 2026Article
- Temporal variations and spatial clusters of diarrheal diseases before and during the COVID-19 pandemic in Jakarta province, Indonesia.BMC public health · 2025Article
- Influences of Maternal, Child, and Household Factors on Diarrhea Management in Ecuador.Children (Basel, Switzerland) · 2025Article
- Geospatial distribution of unimproved water source and sanitation facilities in Ethiopia: evidence from the latest demographic and health survey (2019).Scientific reports · 2025Article
- Is heat wave a predictor of diarrhoea in Dhaka, Bangladesh? A time-series analysis in a South Asian tropical monsoon climate.PLOS global public health · 2024Article
- Distribution ofMedicine in microecology · 2023Article
- Effects of High Temperature and Heavy Precipitation on Drinking Water Quality and Child Hand Contamination Levels in Rural Kenya.Environmental science & technology · 2023Article
- Article
- Seasonal variation of diarrhoeal pathogens among Guinea-Bissauan children under five years of age.PLoS neglected tropical diseases · 2023Article
- Effects of Ambient Temperature, Relative Humidity, and Precipitation on Diarrhea Incidence in Surabaya.International journal of environmental research and public health · 2023Article
- Article
- Neighbors' use of water and sanitation facilities can affect children's health: a cohort study in Mozambique using a spatial approach.BMC public health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
Diarrheal disease remains a leading cause of morbidity in areas with limited access to safe water and sanitation. As water and sanitation interventions continue to be implemented, it will be important to understand the ecological context in which they can prevent diarrhea. We conducted six serial case control studies in Ecuador to estimate the risk of diarrhea from unimproved water and sanitation and the potential for effect modification by rainfall. Unimproved water source and unimproved sanitation increased the adjusted odds of diarrhea (odds ratio [OR] = 3.6, 95% confidence interval [95% CI] = 1.7-7.8 and OR = 1.7, 95% CI = 1.2-2.5, respectively). The OR associated with an unimproved water source was highest after maximum rainfall (OR = 6.8, 95% CI = 1.9-24.5), whereas the OR associated with unimproved sanitation was highest after minimal rainfall (OR = 2.9, 95% CI = 1.3-6.6). Our finding that use of safe water sources and improved sanitation facilities are most protective under opposing rainfall conditions highlights the need for integrated interventions to reduce the burden of diarrheal disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.