SynthesisEnvironmental health perspectives2025
Differential Effectiveness of Water, Sanitation, and Handwashing Interventions to Reduce Child Diarrhea in Dry and Rainy Seasons: A Systematic Review and Meta-Analysis of Intervention Trials.
Synthesis in Environmental health perspectives, 2025. 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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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.
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Who cites it
11 citing papers in PubMed.
- Waterborne diseases and climate change.Nature reviews. Microbiology · 2026Review
- Vulnerability to climate-driven pathogen-specific diarrheal diseases: secondary analysis from the Global Enteric Multicenter Study and Vaccine Impact on Diarrhea in Africa follow-up.Nature communications · 2026Article
- Seasonally Varying Effects of Improved Water, Sanitation, and Handwashing Interventions onOpen forum infectious diseases · 2026Article
- Rainfall and temperature influence effectiveness of on-site sanitation intervention against E. coli contamination in Bangladeshi households.International journal of hygiene and environmental health · 2026Article
- Thirty-one-year trends in diarrheal mortality and disability-adjusted life years attributable to lack of handwashing facilities.Tropical medicine and health · 2026Article
- Socioecological drivers of water, sanitation, and hygiene (WASH) choices: A qualitative analysis of maternal perspectives in northwest Ecuador.PLOS water · 2026Article
- Changes in household hygiene behaviors and multiple childhood health outcomes following health-behavioral education and health-care facility support: a pre-post intervention study.Frontiers in public health · 2026Article
- Seasonally varying effects of improved water, sanitation and handwashing interventions on Giardia infection in Bangladesh.medRxiv : the preprint server for health sciences · 2025Article
- Invited Perspective: Understanding the Links between Weather and Environmental Health to Strengthen Climate Resilience.Environmental health perspectives · 2025Article
- Burden of microbial pathogens-associated infectious diseases in Asian older adults: a systematic analysis derived from the global burden of disease 2021.Frontiers in public health · 2025Article
- The GBD 2021 perspective: COVID-19's impact on diarrheal mortality and etiological trends, 1990-2021.Frontiers in cellular and infection microbiology · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundStudies evaluating how water, sanitation, and/or handwashing (WASH) interventions in low- and middle-income countries impact diarrheal diseases have shown inconsistent results. The prevalence of enteric pathogen infections and diarrhea are highly seasonal and climate-sensitive, which could explain heterogeneous findings. Understanding how season influences the effectiveness of WASH interventions is critical for informing intervention approaches that will be resistant under the varying weather conditions that climate change will bring.
methodsWe conducted a systematic review of the literature and meta-analysis to test whether and to what extent the impact of WASH interventions on diarrhea differs by season. We searched the literature for randomized and nonrandomized controlled WASH intervention trials and identified the season in which data were collected-rainy, dry, or both-for each study using proximate land station weather datasets. We compared the relative risk (RR) estimates for the impact of interventions on diarrhea for each study, stratified by season, and analyzed estimates using meta-analysis and meta-regression. This study is registered with PROSPERO, CRD42021231137.
resultsA total of 50 studies met the inclusion criteria, resulting in 34 drinking water intervention estimates, 8 sanitation intervention estimates, and 14 handwashing intervention estimates. Of the total studies, 60% (
conclusionsEstimates of the seasonal impact of WASH interventions revealed larger effects in the dry season than in the rainy season overall and for water and handwashing interventions in particular. These patterns likely affected previous estimates of intervention effectiveness, which included more dry season estimates. These findings suggest the need to collect data across seasons and report seasonally stratified results to allow for more accurate estimates of the burden of disease impacted by WASH investments and to improve projections of potential impacts of these interventions under future climate conditions. These findings also underscore the need for robust WASH interventions designed to be resistant to seasonal variations in temperature and rainfall now and under future climate change scenarios. https://doi.org/10.1289/EHP14502.
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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.