SynthesisTropical medicine & international health : TM & IH2014
Global assessment of exposure to faecal contamination through drinking water based on a systematic review.
Synthesis in Tropical medicine & international health : TM & IH, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
124 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Bacteriological quality of drinking water and its associated factors in Ethiopia: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Prevalence and epidemiological distribution of indicators of pathogenic bacteria in households drinking water in Ethiopia: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Fecal Indicator Bacteria Data to Characterize Drinking Water Quality in Low-Resource Settings: Summary of Current Practices and Recommendations for Improving Validity.International journal of environmental research and public health · 2021Pooled it
- Giardia spp., the most ubiquitous protozoan parasite in Argentina: human, animal and environmental surveys reported in the last 40 years.Parasitology research · 2020Pooled it
- Pooled it
- Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review.PLoS neglected tropical diseases · 2017Pooled it
- Indicators for Monitoring Water, Sanitation, and Hygiene: A Systematic Review of Indicator Selection Methods.International journal of environmental research and public health · 2016Pooled it
- Association of Supply Type with Fecal Contamination of Source Water and Household Stored Drinking Water in Developing Countries: A Bivariate Meta-analysis.Environmental health perspectives · 2015Pooled it
- A Systematic Review and Meta-Analysis of Fecal Contamination and Inadequate Treatment of Packaged Water.PloS one · 2015Pooled it
- A Stepped Wedge Cluster-Randomized Trial Assessing the Impact of a Riverbank Filtration Intervention to Improve Access to Safe Water on Health in Rural India.The American journal of tropical medicine and hygiene · 2020Trial
- Trial
- Costs and cost-effectiveness of three point-of-use water treatment technologies added to community-based treatment of severe acute malnutrition in Sindh Province, Pakistan.Global health action · 2019Trial
- Human fecal and pathogen exposure pathways in rural Indian villages and the effect of increased latrine coverage.Water research · 2016Trial
- Bayesian modeling of Escherichia coli contamination in household drinking water in Bangladesh: evidence from the Multiple Indicator Cluster Survey 2019.International health · 2026Article
- Spatial assessment of Water, Sanitation, and Hygiene (WASH) infrastructure, groundwater quality, and their association with childhood diarrhoeal risk in India.BMC public health · 2026Article
- Protocols for genomic epidemiology and source attribution of enteric bacteria causing diarrhoeal disease across Africa.BMJ open · 2026Article
- Faecal Coliforms andMicroorganisms · 2026Article
- Fecal contamination of drinking water from source to point of use and associated factors among households in Debre-Tabor town, Northwest Ethiopia.Tropical diseases, travel medicine and vaccines · 2026Article
- Clinical, lifestyle, environmental and dietary determinants of malnutrition in adolescents on antiretroviral therapy in Ethiopia.PLOS global public health · 2026Article
- Safely managed drinking water service use and child diarrhoea based on evidence from 24 countries.Nature water · 2026Article
64 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
objectivesTo estimate exposure to faecal contamination through drinking water as indicated by levels of Escherichia coli (E. coli) or thermotolerant coliform (TTC) in water sources.
methodsWe estimated coverage of different types of drinking water source based on household surveys and censuses using multilevel modelling. Coverage data were combined with water quality studies that assessed E. coli or TTC including those identified by a systematic review (n = 345). Predictive models for the presence and level of contamination of drinking water sources were developed using random effects logistic regression and selected covariates. We assessed sensitivity of estimated exposure to study quality, indicator bacteria and separately considered nationally randomised surveys.
resultsWe estimate that 1.8 billion people globally use a source of drinking water which suffers from faecal contamination, of these 1.1 billion drink water that is of at least 'moderate' risk (>10 E. coli or TTC per 100 ml). Data from nationally randomised studies suggest that 10% of improved sources may be 'high' risk, containing at least 100 E. coli or TTC per 100 ml. Drinking water is found to be more often contaminated in rural areas (41%, CI: 31%-51%) than in urban areas (12%, CI: 8-18%), and contamination is most prevalent in Africa (53%, CI: 42%-63%) and South-East Asia (35%, CI: 24%-45%). Estimates were not sensitive to the exclusion of low quality studies or restriction to studies reporting E. coli.
conclusionsMicrobial contamination is widespread and affects all water source types, including piped supplies. Global burden of disease estimates may have substantially understated the disease burden associated with inadequate water services.
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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.