SynthesisBMC infectious diseases2023
Associations of water, sanitation, and hygiene with typhoid fever in case-control studies: a systematic review and meta-analysis.
Synthesis in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Length of hospital stay and associated treatment costs for patients with susceptible and antibiotic-resistantBMJ open · 2025Pooled it
- Seroincidence Rate of Typhoidal Salmonella in Children, Kenya, 2017-2018.Emerging infectious diseases · 2026Article
- Phase II multicentre double-blind randomised controlled trial of a Bivalent VaccInation againstBMJ open · 2026Article
- Molecular Insights into the MdtABC Efflux Pump Genes in ClinicalCurrent pharmaceutical design · 2026Article
- Article
- Microarray patch vaccines for typhoid conjugate vaccines: A global cost-effectiveness analysis.Vaccine · 2025Article
- Time series data on typhoid fever incidence during outbreaks from 2000 to 2022.Scientific data · 2025Article
- Seroprevalence of Typhoid Fever and Its Associated Risk Factors Among Clinically Diagnosed Febrile Patients Visiting the Outpatient Department at Debark Hospital and Drug Susceptibility Patterns of Isolates.BioMed research international · 2025Article
- Sociodemographic and clinical factors influencing typhoid fever prevalence and multidrug resistance in Niger State, Nigeria.PloS one · 2025Article
- Field Effectiveness of a Typhoid Conjugate Vaccine: The 2018 Navi Mumbai Pediatric TCV Campaign.The American journal of tropical medicine and hygiene · 2024Article
- Evolving Epidemiology and Antibiotic Resistance in Enteric Fever: A Comprehensive Review.Cureus · 2024Review
- Water pollution, cholera, and the role of probiotics: a comprehensive review in relation to public health in Bangladesh.Frontiers in microbiology · 2024Review
- Typhoid fever.Nature reviews. Disease primers · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWater, sanitation, and hygiene (WASH) play a pivotal role in controlling typhoid fever, as it is primarily transmitted through oral-fecal pathways. Given our constrained resources, staying current with the most recent research is crucial. This ensures we remain informed about practical insights regarding effective typhoid fever control strategies across various WASH components. We conducted a systematic review and meta-analysis of case-control studies to estimate the associations of water, sanitation, and hygiene exposures with typhoid fever.
methodsWe updated the previous review conducted by Brockett et al. We included new findings published between June 2018 and October 2022 in Web of Science, Embase, and PubMed. We used the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool for risk of bias (ROB) assessment. We classified WASH exposures according to the classification provided by the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation, and Hygiene (JMP) update in 2015. We conducted the meta-analyses by only including studies that did not have a critical ROB in both Bayesian and frequentist random-effects models.
resultsWe identified 8 new studies and analyzed 27 studies in total. Our analyses showed that while the general insights on the protective (or harmful) impact of improved (or unimproved) WASH remain the same, the pooled estimates of OR differed. Pooled estimates of limited hygiene (OR = 2.26, 95% CrI: 1.38 to 3.64), untreated water (OR = 1.96, 95% CrI: 1.28 to 3.27) and surface water (OR = 2.14, 95% CrI: 1.03 to 4.06) showed 3% increase, 18% decrease, and 16% increase, respectively, from the existing estimates. On the other hand, improved WASH reduced the odds of typhoid fever with pooled estimates for improved water source (OR = 0.54, 95% CrI: 0.31 to 1.08), basic hygiene (OR = 0.6, 95% CrI: 0.38 to 0.97) and treated water (OR = 0.54, 95% CrI: 0.36 to 0.8) showing 26% decrease, 15% increase, and 8% decrease, respectively, from the existing estimates.
conclusionsThe updated pooled estimates of ORs for the association of WASH with typhoid fever showed clear changes from the existing estimates. Our study affirms that relatively low-cost WASH strategies such as basic hygiene or water treatment can be an effective tool to provide protection against typhoid fever in addition to other resource-intensive ways to improve WASH.
trial registrationPROSPERO 2021 CRD42021271881.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.