ArticleTropical medicine & international health : TM & IH2017
Household sanitation is associated with lower risk of bacterial and protozoal enteric infections, but not viral infections and diarrhoea, in a cohort study in a low-income urban neighbourhood in Vellore, India.
Article in Tropical medicine & international health : TM & IH, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Prevention of human exposure to livestock faecal waste in the household: a scoping study of interventions conducted in sub-Saharan Africa.BMC public health · 2023Pooled it
- Examining the effect of neighborhood sanitation coverage on childhood diarrheal disease in rural Bangladesh.International journal of hygiene and environmental health · 2026Trial
- Associations between enteric pathogen carriage and height-for-age, weight-for-age and weight-for-height in children under 5 years old in urban Dhaka, Bangladesh.Epidemiology and infection · 2020Trial
- Fecal carriage, risk factors, and antimicrobial susceptibility patterns of Salmonella from lactating cows and contact humans at the dairy farm level in Mekelle and Southeast Zones of Tigrai, Northern Ethiopia.BMC infectious diseases · 2025Article
- Water, sanitation, and hygiene (WASH) factors and the incidence of communicable diseases in Urban Bangladesh: Evidence from municipal areas.PLoS neglected tropical diseases · 2025Article
- Impact of water, sanitation, and hygiene indicators on enteric viral pathogens among under-5 children in low resource settings.The Science of the total environment · 2025Article
- Net benefit of smaller human populations to environmental integrity and individual health and wellbeing.Frontiers in public health · 2024Review
- Exploring Survey-Based Water, Sanitation, and Animal Associations With Enteric Pathogen Carriage: Comparing Results in a Cohort of Cases With Moderate-to-Severe Diarrhea to Those in Controls in the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Assessment of sanitation and drinking water facilities among slum households in Bhubaneswar, Odisha - A cross-sectional study.Journal of family medicine and primary care · 2023Article
- Household profiles of neglected tropical disease symptoms among children: A latent class analysis of built-environment features of Tanzanian households using the Demographic and Health Survey.Journal of global health · 2022Article
- Higher pathogen load in children from Mozambique vs. USA revealed by comparative fecal microbiome profiling.ISME communications · 2022Article
- Water, Sanitation, and Hygiene (WaSH) practices and morbidity status in a rural community: findings from a cross-sectional study in Odisha, India.Journal of preventive medicine and hygiene · 2021Article
- Associations between Household-Level Exposures and All-Cause Diarrhea and Pathogen-Specific Enteric Infections in Children Enrolled in Five Sentinel Surveillance Studies.International journal of environmental research and public health · 2020Article
- Human faeces-associated extended-spectrum β-lactamase-producing Escherichia coli discharge into sanitation systems in 2015 and 2030: a global and regional analysis.The Lancet. Planetary health · 2020Article
- Environmental and spatial determinants of enteric pathogen infection in rural Lao People's Democratic Republic: A cross-sectional study.PLoS neglected tropical diseases · 2020Article
- Diarrhea in under Five Year-Old Children in Nepal: A Spatiotemporal Analysis Based on Demographic and Health Survey Data.International journal of environmental research and public health · 2020Article
- Viral Pathogen-Specific Clinical and Demographic Characteristics of Children with Moderate-to-Severe Diarrhea in Rural Bangladesh.The American journal of tropical medicine and hygiene · 2019Article
- The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years.PLoS neglected tropical diseases · 2019Article
- Associations between open drain flooding and pediatric enteric infections in the MAL-ED cohort in a low-income, urban neighborhood in Vellore, India.BMC public health · 2019Article
- High Rates of Exposures to Waterborne Pathogens in Indigenous Communities in the Amazon Region of Ecuador.The American journal of tropical medicine and hygiene · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study examined associations between household sanitation and enteric infection - including diarrhoeal-specific outcomes - in children 0-2 years of age in a low-income, dense urban neighbourhood.
methodsAs part of the MAL-ED study, 230 children in a low-income, urban, Indian neighbourhood provided stool specimens at 14-17 scheduled time points and during diarrhoeal episodes in the first 2 years of life that were analysed for bacterial, parasitic (protozoa and helminths) and viral pathogens. From interviews with caregivers in 100 households, the relationship between the presence (and discharge) of household sanitation facilities and any, pathogen-specific, and diarrhoea-specific enteric infection was tested through mixed-effects Poisson regression models.
resultsFew study households (33%) reported having toilets, most of which (82%) discharged into open drains. Controlling for season and household socio-economic status, the presence of a household toilet was associated with lower risks of enteric infection (RR: 0.91, 95% CI: 0.79-1.06), bacterial infection (RR: 0.87, 95% CI: 0.75-1.02) and protozoal infection (RR: 0.64, 95% CI: 0.39-1.04), although not statistically significant, but had no association with diarrhoea (RR: 1.00, 95% CI: 0.68-1.45) or viral infections (RR: 1.12, 95% CI: 0.79-1.60). Models also suggested that the relationship between household toilets discharging to drains and enteric infection risk may vary by season.
conclusionsThe presence of a household toilet was associated with lower risk of bacterial and protozoal enteric infections, but not diarrhoea or viral infections, suggesting the health effects of sanitation may be more accurately estimated using outcome measures that account for aetiologic agents.
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