ArticleBMJ open2017
Does household access to improved water and sanitation in infancy and childhood predict better vocabulary test performance in Ethiopian, Indian, Peruvian and Vietnamese cohort studies?
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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Who cites it
10 citing papers in PubMed, 28 citations in OpenAlex.
- Trial
- ASSESSMENT OF CAREGIVERS' KNOWLEDGE, RETENTION AND UTILIZATION OF CHILD HEALTH CARDS IN OYO STATE, NIGERIA: A MIXED METHOD STUDY WITH A CONVERGENT DESIGN.Annals of Ibadan postgraduate medicine · 2025Article
- Trajectories and social determinants of child cognitive development: a prospective cohort study from infancy through middle childhood in Dhaka, Bangladesh.The Lancet regional health. Southeast Asia · 2025Article
- Assessing harmonized intelligence measures in a multinational study.Global mental health (Cambridge, England) · 2024Article
- Inadequate Access to Potable Water Impacts Early Childhood Development in Low-Income Areas in Cape Town, South Africa.Annals of global health · 2023Article
- Modeling Enteropathy or Diarrhea with the Top Bacterial and Protozoal Pathogens: Differential Determinants of Outcomes.ACS infectious diseases · 2021Review
- Community Determinants of Physical Growth and Cognitive Development among Indian Children in Early Childhood: A Multivariate Multilevel Analysis.International journal of environmental research and public health · 2019Article
- Media Access is Associated with Knowledge of Optimal Water, Sanitation and Hygiene Practices in Tanzania.International journal of environmental research and public health · 2019Article
- Effect of water quality, sanitation, hand washing, and nutritional interventions on child development in rural Bangladesh (WASH Benefits Bangladesh): a cluster-randomised controlled trial.The Lancet. Child & adolescent health · 2018Article
- Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 4 countries.
Funding
Abstract
objectiveTest associations between household water and sanitation (W&S) and children's concurrent and subsequent Peabody Picture Vocabulary Test (PPVT) scores.
designProspective cohort study.
settingEthiopia, India, Peru, Vietnam.
participants7269 children. PRIMARY OUTCOME MEASURES: PPVT scores at 5 and 8 years. Key exposure variables were related to W&S, and collected at 1, 5 and 8 years, including 'improved' water (eg, piped, public tap or standpipe) and 'improved' toilets (eg, collection, storage, treatment and recycling of human excreta).
resultsAccess to improved water at 1 year was associated with higher language scores at 5 years (3/4 unadjusted associations) and 8 years (4/4 unadjusted associations). Ethiopian children with access to improved water at 1 year had test scores that were 0.26 SD (95% CI 0.17 to 0.36) higher at 5 years than children without access. Access to improved water at 5 years was associated with higher concurrent PPVT scores (in 3/4 unadjusted associations), but not later scores (in 1/4 unadjusted associations). 5-year-old Peruvian children with access to improved water had better concurrent performance on the PPVT (0.44 SD, 95% CI 0.30 to 0.59) than children without access to improved water. Toilet access at 1 year was also associated with better PPVT scores at 5 years (3/4 unadjusted associations) and sometimes associated with test results at 8 years (2/4 unadjusted associations). Toilet access at 5 years was associated with concurrent PPVT scores (3/4 unadjusted associations). More than half of all associations in unadjusted models (water and toilets) persisted in adjusted models, particularly for toilets in India, Peru and Vietnam.
conclusionsAccess to 'improved' water and toilets had independent associations with children's PPVT scores that often persisted with adjustment for covariates. Our findings suggest that effects of W&S may go beyond subacute and acute infections and physical growth to include children's language performance, a critical component of cognitive development.
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