ArticleTropical medicine and health2023
Impact of access to improved water and sanitation on diarrhea reduction among rural under-five children in low and middle-income countries: a propensity score matched analysis.
Article in Tropical medicine and health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Effectiveness of infrastructural interventions to improve access to safe drinking water in Latin America and the Caribbean on the burden of diarrhoea in children <5 years: a systematic literature review and narrative synthesis.Global health action · 2025Pooled it
- Global childhood diarrhoea prevalence and its determinants: a systematic meta-analytic assessment, 1985-2024.EBioMedicine · 2025Pooled it
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- Determinants and district-level variation in childhood undernutrition in Sindh, Pakistan: evidence from MICS 2018.BMC nutrition · 2026Article
- Knowledge, Attitudes, and Practices on Fecal-Oral Disease Prevention and Social Acceptability of Compost Latrines in Nyamugo Health Area, Bukavu, Democratic Republic of the Congo: Mixed Methods Formative Study.JMIR formative research · 2026Article
- Emergence of human enteric adenovirus F41 among children with gastroenteritis in North-central Bangladesh, 2022-2024.Scientific reports · 2026Article
- Household vulnerability to climate impacts on WASH and risk mitigation in informal settlements of Eastern Uganda.Scientific reports · 2026Article
- Maternal exposure to intimate partner violence and its association with diarrhoea prevalence and treatment among children under five in Nepal.BMC public health · 2026Article
- Mechanistic insights into the antidiarrheal action of phlorizin: modulation of TLR4/NF-κB, PI3K/AKT, and HIF-1 signalling with antispasmodic and antimicrobial effects.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
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- Global burden of diarrheal diseases attributable to 13 pathogens in children under five: a comprehensive analysis from GBD 2021.Frontiers in pediatrics · 2026Article
- Article
- Trends and Risk Factors For Childhood Diarrhoea in Rwanda: A Secondary Data Analysis of Three Rwanda Demographic and Health Surveys (RDHS 2010, 2014/15, and 2019/20).Rwanda journal of medicine and health sciences · 2025Article
- Patterns of acute watery diarrhea in Fiji: understanding the implications for water and sanitation services.BMC public health · 2025Article
- Article
- Geospatial analysis of diarrheal disease burden and associated health determinants among under-five children in Karnataka using NFHS data.Scientific reports · 2025Article
- The impact of poverty on child malnutrition and health in Lebanon: the need for multisectoral interventions.International journal for equity in health · 2025Article
- The comorbidities of diarrhea and acute respiratory tract infection and risk factors among under-five children in 45 low- and middle-income countries.Scientific reports · 2025Article
- Relationship Between Domestic Animals, Environmental and Behavioral Factors, and Under-Five Diarrhea in Sidama Region, Ethiopia: A Matched Case-Control Study.Journal of epidemiology and global health · 2025Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiarrhea, the second leading cause of child morbidity and mortality worldwide, is responsible for more than 90% of deaths in children under 5 years of age in low and middle-income countries (LMICs). The high burden of diarrhea is mainly attributable to the limited access to improved water and sanitation. However, the impacts of improved sanitation and drinking water in preventing diarrheal diseases are not well understood. Therefore, this study estimated both the independent and joint effects of improved sanitation and water on diarrhea occurrence among rural under-five children in LMICs.
methodsThe current study utilized secondary data from the Demographic and Health Survey (DHS) datasets conducted between 2016 and 2021 in 27 LMICs. A total weighted sample of 330,866 under-five children was included in the study. We employed propensity score matching analysis (PSMA) to examine the effects of accessing improved water and sanitation on childhood diarrheal disease reduction.
resultsThe prevalence of diarrhea among children under 5 years of age in rural LMICs was 11.02% (95% CI; 10.91%, 11.31%). The probability of developing diarrhea among under-five children from households with improved sanitation and water was 16.6% (Average Treatment Effect on the Treated (ATT) = - 0.166) and 7.4% (ATT = - 0.074) times less likely among those from households with unimproved sanitation and water, respectively. Access to improved water and sanitation is significantly associated with a 24.5% (ATT = - 0.245) reduction of diarrheal disease among under-five children.
conclusionsImproved sanitation and drinking water source reduced the risk of diarrhea among under-five children in LMIC. The effects of both interventions (improved water and sanitation) had a larger impact on the reduction of diarrheal disease than the improvements to water or sanitation alone. Therefore, achieving Sustainable Development Goal 6 (SDG 6) is key to reducing diarrhea among rural under-five children.
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