Trial reportThe Journal of infectious diseases2020
Impact of Water Quality, Sanitation, Handwashing, and Nutritional Interventions on Enteric Infections in Rural Zimbabwe: The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial.
Trial report in The Journal of infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 4 of them syntheses that pooled it.
What it found
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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
77 citing papers in PubMed, 4 syntheses or guidelines pooled it, 107 citations in OpenAlex.
- A systematic review of water, sanitation, and hygiene practices in developing countries: exploring the effects on public health.BMC public health · 2026Pooled it
- Prevalence and determinants of Campylobacter infection in under-five children of East Africa: systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- 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
- Faecal contamination of the environment and child health: a systematic review and individual participant data meta-analysis.The Lancet. Planetary health · 2020Pooled it
- Effects of improved water, sanitation, handwashing, and nutrition on early childhood IgG immune repertoire development againstmSphere · 2026Trial
- Trial
- Understanding the Effectiveness of Water, Sanitation, and Hygiene Interventions: A Counterfactual Simulation Approach to Generalizing the Outcomes of Intervention Trials.Environmental health perspectives · 2024Trial
- Trial
- Trial
- Impact of Biannual Mass Azithromycin Treatment on Enteropathogen Carriage in Children <5 Years Old in Niger.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Effect of biannual azithromycin distribution on antibody responses to malaria, bacterial, and protozoan pathogens in Niger.Nature communications · 2022Trial
- The fecal microbiome and rotavirus vaccine immunogenicity in rural Zimbabwean infants.Vaccine · 2021Trial
- Effect of scheduled antimicrobial and nicotinamide treatment on linear growth in children in rural Tanzania: A factorial randomized, double-blind, placebo-controlled trial.PLoS medicine · 2021Trial
- A randomised controlled feasibility trial of a BabyWASH household playspace: The CAMPI study.PLoS neglected tropical diseases · 2021Trial
- Health Outcomes of an Integrated Behaviour-Centred Water, Sanitation, Hygiene and Food Safety Intervention-A Randomised before and after Trial.International journal of environmental research and public health · 2020Trial
- Effects of improved water, sanitation, and hygiene and improved complementary feeding on environmental enteric dysfunction in children in rural Zimbabwe: A cluster-randomized controlled trial.PLoS neglected tropical diseases · 2020Trial
- Giardia duodenalis infection in the context of a community-based deworming and water, sanitation and hygiene trial in Timor-Leste.Parasites & vectors · 2019Trial
- The gut microbiota in malnutrition.Nature reviews. Microbiology · 2026Review
- Sources and transmission dynamics ofmedRxiv : the preprint server for health sciences · 2026Article
- The Burden and Genomic Characterization ofmedRxiv : the preprint server for health sciences · 2026Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundWe assessed the impact of water, sanitation, and hygiene (WASH) and infant and young child feeding (IYCF) interventions on enteric infections in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe.
methodsWe tested stool samples collected at 1, 3, 6, and 12 months of age and during diarrhea using quantitative molecular diagnostics for 29 pathogens. We estimated the effects of the WASH, IYCF, and combined WASH + IYCF interventions on individual enteropathogen prevalence and quantity, total numbers of pathogens detected, and incidence of pathogen-attributable diarrhea.
resultsWASH interventions decreased the number of parasites detected (difference in number compared to non-WASH arms, -0.07 [95% confidence interval, -.14 to -.02]), but had no statistically significant effects on bacteria, viruses, or the prevalence and quantity of individual enteropathogens after accounting for multiple comparisons. IYCF interventions had no significant effects on individual or total enteropathogens. Neither intervention had significant effects on pathogen-attributable diarrhea.
conclusionsThe WASH interventions implemented in SHINE (improved pit latrine, hand-washing stations, liquid soap, point-of-use water chlorination, and clean play space) did not prevent enteric infections. Transformative WASH interventions are needed that are more efficacious in interrupting fecal-oral microbial transmission in children living in highly contaminated environments.
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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.