ArticleEnvironmental health perspectives2016
Assessing the Association between Thermotolerant Coliforms in Drinking Water and Diarrhea: An Analysis of Individual-Level Data from Multiple Studies.
Article in Environmental health perspectives, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Faecal contamination of the environment and child health: a systematic review and individual participant data meta-analysis.The Lancet. Planetary health · 2020Pooled it
- Trial
- A mixed-effects multilevel Poisson regression analysis of diarrhea prevalence among under-five children in Indonesia.Journal of health, population, and nutrition · 2026Article
- Article
- Using Spatial Technologies to Assess Risk Factors for Diarrheal Disease Under Environmental Variability in Bangladesh: A Machine Learning Study.International journal of environmental research and public health · 2025Article
- Complementary feeding and food handling practices among caregivers in a semi-urban setting in Northern Uganda.African health sciences · 2024Article
- Article
- A multilevel analysis of the predictors of diarrhea among children under 5 years of age in Eswatini.Journal of public health in Africa · 2023Article
- Prevalence and Antimicrobial Susceptibility Profile ofThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2023Article
- An integrative water quality evaluation in two surface water bodies from a tropical agricultural region in Cartago, Costa Rica.Environmental science and pollution research international · 2022Article
- Effects of adding household water filters to Rwanda's Community-Based Environmental Health Promotion Programme: a cluster-randomized controlled trial in Rwamagana district.NPJ clean water · 2022Article
- Article
- Measuring Environmental Exposure to Enteric Pathogens in Low-Income Settings: Review and Recommendations of an Interdisciplinary Working Group.Environmental science & technology · 2020Review
- A Syringe-Based Biosensor to Rapidly Detect Low Levels of Escherichia Coli (ECOR13) in Drinking Water Using Engineered Bacteriophages.Sensors (Basel, Switzerland) · 2020Article
- Determinants of Sanitation and Hygiene Status Among Food Establishments in Addis Ababa, Ethiopia.Environmental health insights · 2020Article
- Diarrheal disease and associated behavioural factors among food handlers in Addis Ababa, Ethiopia.AIMS public health · 2020Article
- The Effectiveness of Sanitary Inspections as a Risk Assessment Tool for Thermotolerant Coliform Bacteria Contamination of Rural Drinking Water: A Review of Data from West Bengal, India.The American journal of tropical medicine and hygiene · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFecally contaminated drinking water is believed to be a major contributor to the global burden of diarrheal disease and a leading cause of mortality among young children. However, recent systematic reviews and results from blinded studies of water quality interventions have raised questions about the risk associated with fecally contaminated water, particularly as measured by thermotolerant coliform (TTC) bacteria, a WHO-approved indicator of drinking water quality.
objectivesWe investigated the association between TTC in drinking water and diarrhea using data from seven previous studies.
methodsWe obtained individual-level data from available field studies that measured TTC levels in household-drinking water and reported prevalence of diarrhea among household members during the days prior to the visit.
resultsThe combined data set included diarrhea prevalence for 26,518 individuals and 8,000 water samples from 4,017 households, yielding 45,052 observations. The odds of diarrhea increased for each log10 increase in TTC/100 mL by 18% (95% CI: 11, 26%) for children < 5 years old and 12% (95% CI: 8, 18%) for all ages. For all ages, the odds of diarrhea increased by 21%, 35% and 49% for those whose household water samples were from 11-100, 101-1,000, and > 1,000 TTC/100 mL, respectively compared to < 1 TTC/100 mL. We found no evidence of increased odds of diarrhea with contamination levels below 11 TTC/100 mL, either in adults or children.
conclusionsOur analysis of individual-level data shows increased risk of diarrhea with increasing levels of TTC in drinking water. These results suggest an association between fecally contaminated water and diarrheal disease and provides support for health-based targets for levels of TTC in drinking water and for interventions to improve drinking water quality to prevent diarrhea. CITATION: Hodge J, Chang HH, Boisson S, Collin SM, Peletz R, Clasen T. 2016. Assessing the association between thermotolerant coliforms in drinking water and diarrhea: an analysis of individual level data from multiple studies. Environ Health Perspect 124:1560-1567; http://dx.doi.org/10.1289/EHP156.
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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.