Trial reportPLoS neglected tropical diseases2019
Effects of water, sanitation, handwashing and nutritional interventions on soil-transmitted helminth infections in young children: A cluster-randomized controlled trial in rural Bangladesh.
Trial report in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01590095 (WASH Benefits Bangladesh), which is not on this map. Cited by 48 papers, 4 of them syntheses that pooled 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.
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.
WASH Benefits Bangladesh: A Cluster Randomized Controlled Trial of the Benefits of Water, Sanitation, Hygiene Plus Nutrition Interventions on Child Growth
Who cites it
48 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Effects of water, sanitation, and hygiene interventions on detection of enteropathogens and host-specific faecal markers in the environment: a systematic review and individual participant data meta-analysis.The Lancet. Planetary health · 2023Pooled it
- Interventions to improve water, sanitation, and hygiene for preventing soil-transmitted helminth infection.The Cochrane database of systematic reviews · 2022Pooled it
- Effect of Sanitation Interventions on Health Outcomes: A Systematic Review of Cluster-Randomized Controlled Trials in Rural Communities of Low- and Middle-Income Countries.International journal of environmental research and public health · 2021Pooled it
- Hand-washing promotion for preventing diarrhoea.The Cochrane database of systematic reviews · 2021Pooled it
- Effectiveness of the BALatrine intervention on soil-transmitted helminth infections in Central Java, Indonesia: a cluster-randomised controlled trial.Nature communications · 2026Trial
- Water, sanitation, handwashing, and nutritional interventions can reduce child antibiotic use: evidence from Bangladesh and Kenya.Nature communications · 2025Trial
- Improved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh.Journal of epidemiology and global health · 2024Trial
- A cluster-randomized trial of water, sanitation, handwashing and nutritional interventions on stress and epigenetic programming.Nature communications · 2024Trial
- Influence of Temperature and Precipitation on the Effectiveness of Water, Sanitation, and Handwashing Interventions against Childhood Diarrheal Disease in Rural Bangladesh: A Reanalysis of the WASH Benefits Bangladesh Trial.Environmental health perspectives · 2024Trial
- Trial
- Effect of sanitation improvements on soil-transmitted helminth eggs in courtyard soil from rural Bangladesh: Evidence from a cluster-randomized controlled trial.PLoS neglected tropical diseases · 2021Trial
- Longitudinal Effects of a Sanitation Intervention on Environmental Fecal Contamination in a Cluster-Randomized Controlled Trial in Rural Bangladesh.Environmental science & technology · 2021Trial
- Trial
- Effects of Single and Combined Water, Sanitation and Handwashing Interventions on Fecal Contamination in the Domestic Environment: A Cluster-Randomized Controlled Trial in Rural Bangladesh.Environmental science & technology · 2018Trial
- Do Sanitation Improvements Reduce Fecal Contamination of Water, Hands, Food, Soil, and Flies? Evidence from a Cluster-Randomized Controlled Trial in Rural Bangladesh.Environmental science & technology · 2018Trial
- Impact and cost-effectiveness of water, sanitation, hygiene, and health education interventions in the control and elimination of soil-transmitted helminthiasis: A scoping review.PLoS neglected tropical diseases · 2026Article
- Behavioural Determinants of Intestinal Nematode Infection Risk Among Children in a Post-Mass-Drug-Administration Setting in Sri Lanka: A Survey of Caregiver Knowledge, Attitudes, and Practices.Tropical medicine and infectious disease · 2026Article
- Intestinal Helminth Infections and Their Association With Nutritional Status and Diarrheal Diseases Among School-Aged Children in North Gondar Zone, Ethiopia.Journal of parasitology research · 2026Article
- Investigating cement-based surfaces as a sustainable flooring solution to improve Ascaris Suum egg removal and inactivation in low-resource settings.PLoS neglected tropical diseases · 2025Article
- Biomarkers of environmental enteric dysfunction and neurodevelopmental outcomes among children in rural Bangladesh and Kenya: a prospective cohort study.The American journal of clinical nutrition · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSoil transmitted helminths (STH) infect >1.5 billion people. Mass drug administration (MDA) effectively reduces infection; however, there is evidence for rapid reinfection and risk of potential drug resistance. We conducted a randomized controlled trial in Bangladesh (WASH Benefits, NCT01590095) to assess whether water, sanitation, hygiene and nutrition interventions, alone and combined, reduce STH in a setting with ongoing MDA. METHODOLOGY/PRINCIPAL
findingsIn 2012-2013, we randomized 720 clusters of 5551 pregnant women into water treatment, sanitation, handwashing, combined water+sanitation+handwashing (WSH), nutrition, nutrition+WSH (N+WSH) or control arms. In 2015-2016, we enrolled 7795 children, aged 2-12 years, of 4102 available women for STH follow-up and collected stool from 7187. We enumerated STH infections with Kato-Katz. We estimated intention-to-treat intervention effects on infection prevalence and intensity. Participants and field staff were not blinded; laboratory technicians and data analysts were blinded. Prevalence among controls was 36.8% for A. lumbricoides, 9.2% for hookworm and 7.5% for T. trichiura. Most infections were low-intensity. Compared to controls, the water intervention reduced hookworm by 31% (prevalence ratio [PR] = 0.69 (0.50,0.95), prevalence difference [PD] = -2.83 (-5.16,-0.50)) but did not affect other STH. Sanitation improvements reduced T. trichiura by 29% (PR = 0.71 (0.52,0.98), PD = -2.17 (-4.03,-0.38)), had a similar borderline effect on hookworm and no effect on A. lumbricoides. Handwashing and nutrition interventions did not reduce any STH. WSH and N+WSH reduced hookworm prevalence by 29-33% (WSH: PR = 0.71 (0.52,0.99), PD = -2.63 (-4.95,-0.31); N+WSH: PR = 0.67 (0.50,0.91), PD = -3.00 (-5.14,-0.85)) and marginally reduced A. lumbricoides. Effects on infection intensity were similar. CONCLUSIONS/SIGNIFICANCE: In a low-intensity infection setting with MDA, we found modest but sustained hookworm reduction from water treatment and combined WSH interventions. Impacts were more pronounced on STH species with short vs. long-term environmental survival. Our findings suggest possible waterborne transmission for hookworm. Water treatment and sanitation improvements can augment MDA to interrupt STH transmission.
trial registrationNCT01590095.
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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.