Evidence map›Paper›PMID 41370917›Full record

Trial reportInternational journal of hygiene and environmental health2026

Examining the effect of neighborhood sanitation coverage on childhood diarrheal disease in rural Bangladesh.

Hannah Van Wyk, Andrew F Brouwer, Jesse Contreras, Mahbubur Rahman, Mahfuza Islam, Amy J Pickering, Benjamin F Arnold, Stephen P Luby, John M Colford, Matthew Freeman and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of hygiene and environmental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Hannah Van WykDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Andrew F BrouwerDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. Electronic address: brouweaf@umich.edu.
Jesse ContrerasDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Mahbubur RahmanEnvironmental Health and WASH, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, 1212, Bangladesh; Global Health and Migration United, Department of Women's and Children's Health, Uppsala University, Sweden.
Mahfuza IslamDepartment of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA.
Amy J PickeringDepartment of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, CA, 94720, USA; Chan Zuckerberg Biohub, San Francisco, CA, 94158, USA.
Benjamin F ArnoldFrancis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA, 94158, USA.
Stephen P LubyWoods Institute for the Environment, Stanford University, Stanford, CA, 94305, USA.
John M ColfordDivision of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA.
Matthew FreemanGangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Ayse ErcumenDepartment of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC, USA.
Joseph N S EisenbergDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. Electronic address: jnse@umich.edu.

Funding

Modeling the Effects of the Environment on Enteric Pathogen DynamicsU01GM110712 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI EISENBERG, JOSEPH N. S. · 2014 to 2018
$3.0M
Source Attribution and Transmission Dynamics of Campylobacter and Shigella Using Culture-Independent Molecular Methods in an Urban Slum in Dhaka, BangladeshR01TW012183 · FIC · UNIVERSITY OF VIRGINIA · PI PLATTS-MILLS, JAMES ALEXANDER, TANIUCHI, MAMI · 2021 to 2025
$2.5M
Bill & Melinda Gates Foundation INV-005081FIC NIH HHS R01 TW012183NIGMS NIH HHS U01 GM110712
6 · The paper itself

Abstract

backgroundNeighborhood-level sanitation coverage may offer significant indirect protection against diarrheal disease, an observation that has been supported by several studies.

methodsWe analyzed the protective effect of neighborhood sanitation coverage using harmonized data from two studies: a randomized control trial (RCT) examining the effectiveness of improved compound-level sanitation and an observational study that collected information on compounds within 100 m of the RCT study compounds. We developed the Neighborhood Sanitation & Fecal Exposure (NSFE) metric, which estimates the fecal contamination at a study compound based on the demographic and sanitation characteristics of the neighborhood. NSFE is a function of the number of individuals and latrine quality at surrounding compounds, the distance to neighboring compounds, and the effectiveness of hygienic and unhygienic latrines relative to open defecation. We modeled the relationship between NSFE and childhood diarrheal prevalence within RCT study compounds. Finally, we examined counterfactual scenarios to understand how much of the observed diarrheal burden was attributable to neighbors' latrine quality.

resultsWe estimated a 3.6-fold increase in diarrheal prevalence between compounds with the highest and lowest NSFE, with about two-thirds of this association concentrated in compounds between the 90th and 100th percentile of NSFE values. In counterfactual scenarios, we estimate that 15.5 % of the entire diarrheal disease burden in children living in the study compounds would be eliminated if all neighboring compounds had high-quality latrines.

conclusionCommunity effects associated with neighborhood sanitation coverage are important drivers of diarrheal disease and should be considered in future designs of sanitation interventions. Our findings support the importance of universal basic sanitation as a target for United Nations Sustainable Development Goal 6.

Indexed as

DiarrheaNeighborhood CharacteristicsSanitationBangladeshChildChild, PreschoolFemaleHumansInfantMalePrevalenceResidence CharacteristicsRural PopulationToilet FacilitiesDiarrheal diseaseFecal contaminationSanitation coverageWASH

Identifiers

PMID41370917
PMCPMC12825392

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Registered trials

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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.