Evidence map›Paper›PMID 37290458›Full record

ArticleLancet (London, England)2023

Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes.

Jennyfer Wolf, Richard B Johnston, Argaw Ambelu, Benjamin F Arnold, Robert Bain, Michael Brauer, Joe Brown, Bethany A Caruso, Thomas Clasen, John M Colford and 11 more

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

Article in Lancet (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 7 pooled it
42.1field-weighted citation impact, top 1% 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

105 citing papers in PubMed, 7 syntheses or guidelines pooled it, 263 citations in OpenAlex.

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45 more citing papers are in PubMed but not listed here.

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

21 authors at 11 institutions in 7 countries.

Jennyfer WolfDepartment of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland. Electronic address: wolfj@who.int.
Richard B JohnstonDepartment of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
Argaw AmbeluDivision of Water and Health, Ethiopian Institution of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia.
Benjamin F ArnoldFI Proctor Foundation, University of California, San Francisco, CA, USA.
Robert BainUNICEF Middle East and North Africa, Amman, Jordan.
Michael BrauerInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Joe BrownDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Bethany A CarusoThe Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Thomas ClasenGangarose Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
John M ColfordDivision of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, USA.
Joanna Esteves MillsDepartment of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
Barbara EvansSchool of Civil Engineering, University of Leeds, Leeds, UK.
Matthew C FreemanGangarose Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Bruce GordonDepartment of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
Gagandeep KangWellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tami Nadu, India.
Claudio F LanataInstituto de Investigación Nutricional, Lima, Peru; School of Medicine, Vanderbilt University, Nashville, TN, USA; Department of Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Kate O MedlicottDepartment of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
Annette Prüss-UstünDepartment of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
Christopher TroegerDepartment of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Sophie BoissonDepartment of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
Oliver CummingDepartment of Disease Control, Faculty of Infectious Tropical Disease, London School of Hygiene & Tropical Medicine, London, UK.
World Health Organization · CHEmory University · USLondon School of Hygiene & Tropical Medicine · GBChristian Medical College, Vellore · INInstitute for Health Metrics and Evaluation · USSan Francisco Foundation · USUniversity of California, Berkeley · USUniversity of Leeds · GBUniversity of North Carolina at Chapel Hill · USUniversity of Washington · USWater and Land Resource Centre · ET

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundAssessments of disease burden are important to inform national, regional, and global strategies and to guide investment. We aimed to estimate the drinking water, sanitation, and hygiene (WASH)-attributable burden of disease for diarrhoea, acute respiratory infections, undernutrition, and soil-transmitted helminthiasis, using the WASH service levels used to monitor the UN Sustainable Development Goals (SDGs) as counterfactual minimum risk-exposure levels.

methodsWe assessed the WASH-attributable disease burden of the four health outcomes overall and disaggregated by region, age, and sex for the year 2019. We calculated WASH-attributable fractions of diarrhoea and acute respiratory infections by country using modelled WASH exposures and exposure-response relationships from two updated meta-analyses. We used the WHO and UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene public database to estimate population exposure to different WASH service levels. WASH-attributable undernutrition was estimated by combining the population attributable fractions (PAF) of diarrhoea caused by unsafe WASH and the PAF of undernutrition caused by diarrhoea. Soil-transmitted helminthiasis was fully attributed to unsafe WASH.

findingsWe estimate that 1·4 (95% CI 1·3-1·5) million deaths and 74 (68-80) million disability-adjusted life-years (DALYs) could have been prevented by safe WASH in 2019 across the four designated outcomes, representing 2·5% of global deaths and 2·9% of global DALYs from all causes. The proportion of diarrhoea that is attributable to unsafe WASH is 0·69 (0·65-0·72), 0·14 (0·13-0·17) for acute respiratory infections, and 0·10 (0·09-0·10) for undernutrition, and we assume that the entire disease burden from soil-transmitted helminthiasis was attributable to unsafe WASH.

interpretationWASH-attributable burden of disease estimates based on the levels of service established under the SDG framework show that progress towards the internationally agreed goal of safely managed WASH services for all would yield major public-health returns.

fundingWHO and Foreign, Commonwealth & Development Office.

Indexed as

Drinking WaterHelminthiasisMalnutritionRespiratory Tract InfectionsCost of IllnessDiarrheaGlobal Burden of DiseaseGlobal HealthHumansHygieneOutcome Assessment, Health CareSanitationDrinking Water

Identifiers

PMID37290458
PMCPMC10290941
OpenAlexW4379467249

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.