ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Survey-Based Assessment of Water, Sanitation, and Animal-Associated Risk Factors for Moderate-to-Severe Diarrhea in the Vaccine Impact on Diarrhea in Africa (VIDA) Study: The Gambia, Mali, and Kenya, 2015-2018.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 14 citations in OpenAlex.
- Animals in child sleeping spaces and unimproved sanitation associated with diarrhea among young children in the Democratic Republic of the Congo: WASHmobile PICHA7 prospective cohort study.Tropical medicine and health · 2026Article
- Prevalence of acute watery diarrhea in vulnerable children, mothers' knowledge, and management: a cross-sectional study from Yemen.Frontiers in pediatrics · 2026Article
- Regional and age-specific global trends associated with infectious diarrhea in children under 14 years old caused by pathogenic microorganisms in 2021.Frontiers in medicine · 2025Article
- The GBD 2021 perspective: COVID-19's impact on diarrheal mortality and etiological trends, 1990-2021.Frontiers in cellular and infection microbiology · 2025Article
- Exploring Associations Between WaSH-Related Health Outcomes and Terrorist Activities in the Sahel: A Scoping Review.Public health reviews · 2025Review
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- Potent and Versatile Biogenically Synthesized Alumina/Nickel Oxide Nanocomposite Adsorbent for Defluoridation of Drinking Water.ACS omega · 2024Article
- The Full Impact of Rotavirus Vaccines in Africa Has Yet to Be Realized.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Exploring Survey-Based Water, Sanitation, and Animal Associations With Enteric Pathogen Carriage: Comparing Results in a Cohort of Cases With Moderate-to-Severe Diarrhea to Those in Controls in the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Prevalence and contributing factors of anaemia among children aged 6-24 months and 25-59 months in Mali.Journal of nutritional science · 2023Article
- Mapping the global, regional, and national burden of diarrheal diseases attributable to unsafe water.Frontiers in public health · 2023Article
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Authors and funding
20 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPediatric exposures to unsafe sources of water, unsafely managed sanitation, and animals are prevalent in low- and middle-income countries. In the Vaccine Impact on Diarrhea in Africa case-control study, we examined associations between these risk factors and moderate-to-severe diarrhea (MSD) in children <5 years old in The Gambia, Kenya, and Mali.
methodsWe enrolled children <5 years old seeking care for MSD at health centers; age-, sex-, and community-matched controls were enrolled at home. Conditional logistic regression models, adjusted for a priori confounders, were used to evaluate associations between MSD and survey-based assessments of water, sanitation, and animals living in the compound.
resultsFrom 2015 to 2018, 4840 cases and 6213 controls were enrolled. In pan-site analyses, children with drinking water sources below "safely managed" (onsite, continuously accessible sources of good water quality) had 1.5-2.0-fold higher odds of MSD (95% confidence intervals [CIs] ranging from 1.0 to 2.5), driven by rural site results (The Gambia and Kenya). In the urban site (Mali), children whose drinking water source was less available (several hours/day vs all the time) had higher odds of MSD (matched odds ratio [mOR]: 1.4, 95% CI: 1.1, 1.7). Associations between MSD and sanitation were site-specific. Goats were associated with slightly increased odds of MSD in pan-site analyses, whereas associations with cows and fowl varied by site.
conclusionsPoorer types and availability of drinking water sources were consistently associated with MSD, whereas the impacts of sanitation and household animals were context-specific. The association between MSD and access to safely managed drinking water sources post-rotavirus introduction calls for transformational changes in drinking water services to prevent acute child morbidity from MSD.
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