SynthesisPloS one2014
Coliform bacteria as indicators of diarrheal risk in household drinking water: systematic review and meta-analysis.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 5 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
51 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Unsafe drinking water and human health: A global umbrella review of disease outcomes, intervention effectiveness, and policy implications.Cell reports. Medicine · 2026Pooled it
- Is detection of enteropathogens and human or animal faecal markers in the environment associated with subsequent child enteric infections and growth: an individual participant data meta-analysis.The Lancet. Global health · 2024Pooled it
- Effects of water, sanitation, and hygiene interventions on detection of enteropathogens and host-specific faecal markers in the environment: a systematic review and individual participant data meta-analysis.The Lancet. Planetary health · 2023Pooled 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
- Faecal contamination of the environment and child health: a systematic review and individual participant data meta-analysis.The Lancet. Planetary health · 2020Pooled it
- Ingestion of Fecal Bacteria along Multiple Pathways by Young Children in Rural Bangladesh Participating in a Cluster-Randomized Trial of Water, Sanitation, and Hygiene Interventions (WASH Benefits).Environmental science & technology · 2020Trial
- Trial
- Point-of-use water treatment improves recovery rates among children with severe acute malnutrition in Pakistan: results from a site-randomized trial.Public health nutrition · 2018Trial
- A Randomized Controlled Trial to Measure Spillover Effects of a Combined Water, Sanitation, and Handwashing Intervention in Rural Bangladesh.American journal of epidemiology · 2018Trial
- Effectiveness of the Hydrogen Sulfide Test as a Water Quality Indicator for Diarrhea Risk in Rural Bangladesh.The American journal of tropical medicine and hygiene · 2017Trial
- The challenge of improving boiling: lessons learned from a randomized controlled trial of water pasteurization and safe storage in Peru.Epidemiology and infection · 2016Trial
- Drinking water quality and enteric disease: a nationwide case-crossover study (2015-2019) in New Zealand.Journal of exposure science & environmental epidemiology · 2026Article
- Dirt Floors and Domestic Animals Are Associated with Soilborne Exposure to Antimicrobial-ResistantEnvironmental science & technology · 2025Article
- Zoonotic and Environmental Sources of Infant Enteric Pathogen Infections Identified with Longitudinal Sampling.Environmental science & technology · 2025Article
- Health risks associated with seasonal water quality in the Hasbani River, Lebanon: a physicochemical and microbiological analysis.Journal of water and health · 2025Article
- Assessment of Bacterial Community and Other Microorganism Along the Lam Takhong Watercourse, Nakhon Ratchasima, Thailand.Current microbiology · 2025Article
- Assessment of groundwater quality for human consumption and its health risks in the Middle Magdalena Valley, Colombia.Scientific reports · 2024Article
- Article
- Effects of High Temperature and Heavy Precipitation on Drinking Water Quality and Child Hand Contamination Levels in Rural Kenya.Environmental science & technology · 2023Article
- Genomics and pathotypes of the many faces of Escherichia coli.FEMS microbiology reviews · 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
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent guidelines recommend the use of Escherichia coli (EC) or thermotolerant ("fecal") coliforms (FC) as indicators of fecal contamination in drinking water. Despite their broad use as measures of water quality, there remains limited evidence for an association between EC or FC and diarrheal illness: a previous review found no evidence for a link between diarrhea and these indicators in household drinking water.
objectivesWe conducted a systematic review and meta-analysis to update the results of the previous review with newly available evidence, to explore differences between EC and FC indicators, and to assess the quality of available evidence.
methodsWe searched major databases using broad terms for household water quality and diarrhea. We extracted study characteristics and relative risks (RR) from relevant studies. We pooled RRs using random effects models with inverse variance weighting, and used standard methods to evaluate heterogeneity and publication bias.
resultsWe identified 20 relevant studies; 14 studies provided extractable results for meta-analysis. When combining all studies, we found no association between EC or FC and diarrhea (RR 1.26 [95% CI: 0.98, 1.63]). When analyzing EC and FC separately, we found evidence for an association between diarrhea and EC (RR: 1.54 [95% CI: 1.37, 1.74]) but not FC (RR: 1.07 [95% CI: 0.79, 1.45]). Across all studies, we identified several elements of study design and reporting (e.g., timing of outcome and exposure measurement, accounting for correlated outcomes) that could be improved upon in future studies that evaluate the association between drinking water contamination and health.
conclusionsOur findings, based on a review of the published literature, suggest that these two coliform groups have different associations with diarrhea in household drinking water. Our results support the use of EC as a fecal indicator in household drinking water.
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What OpenQuestion holds
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.