ArticleInternational journal of epidemiology2019
Assessing longer-term effectiveness of a combined household-level piped water and sanitation intervention on child diarrhoea, acute respiratory infection, soil-transmitted helminth infection and nutritional status: a matched cohort study in rural Odisha, India.
Article in International journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 6 of them syntheses that pooled it.
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Who cites it
34 citing papers in PubMed, 6 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Impact on childhood mortality of interventions to improve drinking water, sanitation, and hygiene (WASH) to households: Systematic review and meta-analysis.PLoS medicine · 2023Pooled it
- 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 sanitation for preventing diarrhoea.The Cochrane database of systematic reviews · 2023Pooled it
- Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings: a systematic review and meta-analysis.Lancet (London, England) · 2022Pooled it
- Interventions to improve water, sanitation, and hygiene for preventing soil-transmitted helminth infection.The Cochrane database of systematic reviews · 2022Pooled it
- Faecal contamination of the environment and child health: a systematic review and individual participant data meta-analysis.The Lancet. Planetary health · 2020Pooled it
- Epidemiology of soil transmitted helminths and risk analysis of hookworm infections in the community: Results from the DeWorm3 Trial in southern India.PLoS neglected tropical diseases · 2021Trial
- 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
- Article
- Water, sanitation, and hygiene in soil-transmitted helminth control: A scoping review of evidence gaps across transmission pathways.PLOS global public health · 2026Article
- Insights into the mechanism of intestinal flora imbalance and immune disorder in co-morbidity of pneumonia and diarrhea in children.Frontiers in pediatrics · 2026Review
- Associations between Fecal Contamination of the Household Environment and Enteric Pathogen Detection in Children Living in Maputo, Mozambique.Environment & health (Washington, D.C.) · 2025Article
- Review
- Urban water network upgrades improve quality and access to drinking water in the PAASIM matched cohort study in Beira, Mozambique.Research square · 2025Article
- Public sanitation interventions and household clean energy adoption: Evidence from China's renovating water supply and toilets.PloS one · 2025Article
- Gaps in the usage and reporting of multiple imputation for incomplete data: findings from a scoping review of observational studies addressing causal questions.BMC medical research methodology · 2024Article
- Analysing the interlinkage between diarrhoea and drinking water faecal contamination in India.Journal of water and health · 2024Article
- Effectiveness of Integrated Social and Behavior Change Communication Interventions in Mass Drug Administration Campaigns in Enhancing Knowledge, Perceptions, and Preventive Practices for Neglected Tropical Diseases in Jimma.Risk management and healthcare policy · 2024Article
- Article
- Opportunities to Interrupt Transmission of Enteropathogens of Poultry Origin in Maputo, Mozambique: A Transmission Model Analysis.Environmental health perspectives · 2023Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOpen defecation is widespread in rural India, and few households have piped water connections. While government and other efforts have increased toilet coverage in India, and evaluations found limited immediate impacts on health, longer-term effects have not been rigorously assessed.
methodsWe conducted a matched cohort study to assess the longer-term effectiveness of a combined household-level piped water and sanitation intervention implemented by Gram Vikas (an Indian NGO) in rural Odisha, India. Forty-five intervention villages were randomly selected from a list of those where implementation was previously completed at least 5 years before, and matched to 45 control villages. We conducted surveys and collected stool samples between June 2015 and October 2016 in households with a child <5 years of age (n = 2398). Health surveillance included diarrhoea (primary outcome), acute respiratory infection (ARI), soil-transmitted helminth infection, and anthropometry.
resultsIntervention villages had higher improved toilet coverage (85% vs 18%), and increased toilet use by adults (74% vs 13%) and child faeces disposal (35% vs 6%) compared with control villages. There was no intervention association with diarrhoea [adjusted OR (aOR): 0.94, 95% confidence interval (CI): 0.74-1.20] or ARI. Compared with controls, children in intervention villages had lower helminth infection (aOR: 0.44, 95% CI: 0.18, 1.00) and improved height-for-age z scores (HAZ) (+0.17, 95% CI: 0.03-0.31).
conclusionsThis combined intervention, where household water connections were contingent on community-wide household toilet construction, was associated with improved HAZ, and reduced soil-transmitted helminth (STH) infection, though not reduced diarrhoea or ARI. Further research should explore the mechanism through which these heterogenous effects on health may occur.
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