ArticleBMC public health2025
Patterns of acute watery diarrhea in Fiji: understanding the implications for water and sanitation services.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiarrheal disease, including acute watery diarrhea (AWD), remains a persistent global health challenge, particularly in settings with inadequate water and sanitation infrastructure. Understanding the local epidemiological features of AWD is a crucial first step to inform effective public health intervention. This study examines the AWD trends in Fiji and their association with water and sanitation service levels as defined by the WHO/UNICEF Joint Monitoring Programme.
methodsThis ecological study analysed longitudinal syndromic surveillance data on AWD cases reported in Fiji's Central and Western Divisions from April 2016 to December 2021, alongside census derived water and sanitation data. Age-specific trends, seasonal patterns, and district-level variations were assessed using descriptive statistics and Pearson's correlation analyses. The associations between AWD incidence, water and sanitation service levels were evaluated using negative binomial regression, adjusting for district-level population confounders. Additionally, population attributable risk (PAR) was calculated to estimate the proportion of AWD cases linked to unimproved water and sanitation services.
resultsChildren under 5 years old (U5) had the highest incidence of AWD throughout the study period, with both age groups showing a seasonal trend from February to April annually. AWD rates declined during the period when COVID-19 travel restrictions were in place. A strong correlation existed between U5 and O5 cases across all years (R = 0.59-0.88; 95% CI: 0.45-0.92; p < 0.001). Nearly 18% of AWD cases were attributable to unimproved water (PAR 17.46%) and sanitation (PAR 17.80%). Access to safely managed water service reduced AWD risk (reference category), while unimproved water (RR 3.42; 95% CI: 2.66-4.38) and sanitation (RR 7.56; 95% CI: 4.21-13.58) service levels posed the highest risks.
conclusionAdvancing access to safely managed water and sanitation is essential to mitigate AWD. Investments in water and sanitation infrastructure particularly in underserved and high-risk areas should be prioritised. The findings underscore the importance of context-specific Water and Sanitation interventions in Pacific Island settings.
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.