Evidence map›Paper›PMID 29143638›Full record

SynthesisBMC public health2017

Water, sanitation and hygiene interventions for acute childhood diarrhea: a systematic review to provide estimates for the Lives Saved Tool.

Nazia Darvesh, Jai K Das, Tyler Vaivada, Michelle F Gaffey, Kumanan Rasanathan, Zulfiqar A Bhutta, Social Determinants of Health Study Team

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC public health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 8 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 8 syntheses or guidelines pooled it, 160 citations in OpenAlex.

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  7. Nutrients · 2020
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  8. Does Basic Sanitation Prevent Diarrhea? Contextualizing Recent Intervention Trials through a Historical Lens.International journal of environmental research and public health · 2019
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5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Nazia DarveshCentre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M6S 1S6, Canada.
Jai K DasDivision of Women and Child Health, Aga Khan University, Karachi, Pakistan.
Tyler VaivadaCentre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M6S 1S6, Canada.
Michelle F GaffeyCentre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M6S 1S6, Canada.
Kumanan RasanathanUNICEF, New York, NY, USA.
Zulfiqar A BhuttaCentre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M6S 1S6, Canada. zulfiqar.bhutta@sickkids.ca.
Social Determinants of Health Study Team
Aga Khan University · PKHospital for Sick Children · CAUnited Nations Children's Fund · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the Sustainable Development Goals (SDGs) era, there is growing recognition of the responsibilities of non-health sectors in improving the health of children. Interventions to improve access to clean water, sanitation facilities, and hygiene behaviours (WASH) represent key opportunities to improve child health and well-being by preventing the spread of infectious diseases and improving nutritional status.

methodsWe conducted a systematic review of studies evaluating the effects of WASH interventions on childhood diarrhea in children 0-5 years old. Searches were run up to September 2016. We screened the titles and abstracts of retrieved articles, followed by screening of the full-text reports of relevant studies. We abstracted study characteristics and quantitative data, and assessed study quality. Meta-analyses were performed for similar intervention and outcome pairs.

resultsPooled analyses showed diarrhea risk reductions from the following interventions: point-of-use water filtration (pooled risk ratio (RR): 0.47, 95% confidence interval (CI): 0.36-0.62), point-of-use water disinfection (pooled RR: 0.69, 95% CI: 0.60-0.79), and hygiene education with soap provision (pooled RR: 0.73, 95% CI: 0.57-0.94). Quality ratings were low or very low for most studies, and heterogeneity was high in pooled analyses. Improvements to the water supply and water disinfection at source did not show significant effects on diarrhea risk, nor did the one eligible study examining the effect of latrine construction.

conclusionsVarious WASH interventions show diarrhea risk reductions between 27% and 53% in children 0-5 years old, depending on intervention type, providing ample evidence to support the scale-up of WASH in low and middle-income countries (LMICs). Due to the overall low quality of the evidence and high heterogeneity, further research is required to accurately estimate the magnitude of the effects of these interventions in different contexts.

Indexed as

Health PromotionAcute DiseaseChild, PreschoolDiarrheaHumansHygieneInfantInfant, NewbornProgram EvaluationRandomized Controlled Trials as TopicSanitationSoftwareWaterWaterDiarrheaHygieneLiSTLives saved toolSanitationWashWater

Identifiers

PMID29143638
PMCPMC5688426
OpenAlexW2767294195

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.