Evidence map›Paper›PMID 36414946›Full record

ArticleBMC infectious diseases2022

Equity in access to safely managed sanitation and prevalence of diarrheal diseases in Bangladesh: a national and sub-national analysis.

Jahanara Akter, Md Rashedul Islam, Shamima Akter, Md Mizanur Rahman, Fahima Hossain, Md Rifat Anam, Md Ashraful Alam, Papia Sultana, Shahedur Rashid

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

Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.7field-weighted citation impact, top 17% 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

7 citing papers in PubMed, 18 citations in OpenAlex.

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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

9 authors at 6 institutions in 2 countries.

Jahanara AkterGlobal Public Health Research Foundation, Dhaka, Bangladesh.
Md Rashedul IslamHitotsubashi Institute for Advanced Study, Hitotsubashi University, Kunitachi, Japan. rashedruhrd@gmail.com.
Shamima AkterHitotsubashi Institute for Advanced Study, Hitotsubashi University, Kunitachi, Japan.
Md Mizanur RahmanHitotsubashi Institute for Advanced Study, Hitotsubashi University, Kunitachi, Japan.
Fahima HossainGlobal Public Health Research Foundation, Dhaka, Bangladesh.
Md Rifat AnamGlobal Public Health Research Foundation, Dhaka, Bangladesh.
Md Ashraful AlamDepartment of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Papia SultanaUniversity of Rajshahi, Rajshahi, Bangladesh.
Shahedur RashidJahangirnagar University, Dhaka, Bangladesh.
Hitotsubashi University · JPChild Health Research Foundation · BDJahangirnagar University · BDNational University Bangladesh · BDThe University of Tokyo · JPUniversity of Rajshahi · BD

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Bangladesh, safely managed sanitation (SMS) coverage is low, and diarrheal disease is a significant health problem. This study estimated the inequality in access to SMS facilities at the national and sub-national levels and assessed the prevalence of diarrheal diseases in connection with these improved facilities.

methodsData were extracted from the Bangladesh Demographic and Health Survey, conducted during 2017-2018. SMS was defined as using an improved sanitation facility, which designed to hygienically separate excreta from human contact and include the use of a flush toilet connected to piped sewer system, septic tank, ventilated improved pit latrine, pit latrine with a slab, and composting toilet. The slope index of inequality (SII) and multi-level regression models were used for inequality and risk factors of SMS respectively.

resultsThe national coverage of SMS was 44.0% (45.3% and 43.5% in urban and rural areas, respectively). At the sub-national level, the lowest and highest coverage of SMS was observed in Mymensingh (32.9%) and Chittagong (54.1%) divisions, respectively. The national level SII indicated that wealthy households had access to higher SMS by 60.8 percentage points than poor households. Additionally, greater inequality was observed in rural areas, which was 71.9 percentage points higher in the richest households than in the poorest households. The coverage gap between the rich and poor was highest in the Sylhet division (85.3 percentage points higher in rich than in poor) and lowest in Dhaka (34.9 percentage points). Old and highly educated household heads and richest households had better access to higher levels of adequate sanitation. After adjusting for confounding variables, the prevalence of diarrheal disease was 14.0% lower in the SMS user group than in their counterparts.

conclusionSubstantial inequalities in access to SMS exist at both national and sub-national levels of Bangladesh, with the prevalence of diarrhea being lower among SMS users. These findings may help to prioritize resources for reducing inequality and expanding the coverage of improved sanitation in Bangladesh.

Indexed as

Rural PopulationSanitationBangladeshDiarrheaHumansPrevalenceDiarrheal diseaseInequalityMulti-level analysisSanitation

Identifiers

PMID36414946
PMCPMC9682820
OpenAlexW4309684843

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.