Water, Sanitation and Hygiene : Interventions and Diarrhoea

Many individual studies have reported results of interventions intended to reduce illness through improvements in drinking water, sanitation facilities and hygiene practices. This paper provides a formal systematic review and meta-analysis examinin...

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Main Authors:	Fewtrell, Lorna, Colford, John M. Jr.
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	ADEQUATE SANITATION AGED ANIMAL EXCRETA BASIC SANITATION BASIC WATER SUPPLY CHILD MORTALITY CHOLERA CONTAMINANTS DIARRHEAL DISEASES DISEASE RISK DRINKING WATER DRINKING WATER SUPPLY DYSENTERY EPIDEMIOLOGY EXCRETA DISPOSAL GROUND WATER HAND PUMP HEALTH EDUCATION HOUSEHOLD CONNECTION HOUSEHOLD CONNECTIONS HUMAN EXCRETA HUMAN FAECES HYGIENE HYGIENE BEHAVIOURS HYGIENE EDUCATION HYGIENE PRACTICES HYGIENE PROMOTION HYGIENIC BEHAVIOUR INADEQUATE WATER INADEQUATE WATER SUPPLY INCIDENCE OF DIARRHOEA INFECTIOUS DISEASES INTERVENTION MORBIDITY NUTRITION PIT LATRINE PROVISION OF SERVICES PROVISION OF WATER PUBLIC HEALTH PUBLIC STANDPIPE QUALITY RAINWATER COLLECTION RIVERS SAFE WATER SANITATION SANITATION FACILITIES SANITATION SERVICES SANITATION SITUATION SANITATION WATER SANITATION WATER SUPPLY SURFACE WATER USE OF WATER WASHING WASTE WATER WATER WATER CONSUMPTION WATER QUALITY WATER QUANTITY WATER SECTOR WATER SOURCE WATER SUPPLIES WATER SUPPLY WATER TANKER WATER TREATMENT
Online Access:	http://documents.worldbank.org/curated/en/2004/07/6566654/water-sanitation-hygiene-interventions-diarrhoea-systematic-review-meta-analysis http://hdl.handle.net/10986/13742

id	okr-10986-13742
recordtype	oai_dc
spelling	okr-10986-137422021-04-23T14:03:09Z Water, Sanitation and Hygiene : Interventions and Diarrhoea Fewtrell, Lorna Colford, John M. Jr. ADEQUATE SANITATION AGED ANIMAL EXCRETA BASIC SANITATION BASIC WATER SUPPLY CHILD MORTALITY CHOLERA CONTAMINANTS DIARRHEAL DISEASES DISEASE RISK DRINKING WATER DRINKING WATER SUPPLY DYSENTERY EPIDEMIOLOGY EXCRETA DISPOSAL GROUND WATER HAND PUMP HEALTH EDUCATION HOUSEHOLD CONNECTION HOUSEHOLD CONNECTIONS HUMAN EXCRETA HUMAN FAECES HYGIENE HYGIENE BEHAVIOURS HYGIENE EDUCATION HYGIENE PRACTICES HYGIENE PROMOTION HYGIENIC BEHAVIOUR INADEQUATE WATER INADEQUATE WATER SUPPLY INCIDENCE OF DIARRHOEA INFECTIOUS DISEASES INTERVENTION MORBIDITY NUTRITION PIT LATRINE PROVISION OF SERVICES PROVISION OF WATER PUBLIC HEALTH PUBLIC STANDPIPE QUALITY RAINWATER COLLECTION RIVERS SAFE WATER SANITATION SANITATION FACILITIES SANITATION SERVICES SANITATION SITUATION SANITATION WATER SANITATION WATER SUPPLY SURFACE WATER USE OF WATER WASHING WASTE WATER WATER WATER CONSUMPTION WATER QUALITY WATER QUANTITY WATER SECTOR WATER SOURCE WATER SUPPLIES WATER SUPPLY WATER TANKER WATER TREATMENT Many individual studies have reported results of interventions intended to reduce illness through improvements in drinking water, sanitation facilities and hygiene practices. This paper provides a formal systematic review and meta-analysis examining the evidence of the effectiveness of these interventions. Through a comprehensive literature search and bibliographic review, 2120 titles published prior to June 26th, 2003 were screened, 336 papers were obtained for a more thorough examination, and 64 of these papers (representing 60 distinct studies) were identified which detailed water supply, water quality, sanitation, hygiene or multifactorial interventions and examined diarrhoea morbidity as a health outcome in non-outbreak conditions. Data were extracted from these papers and pooled through meta-analysis to provide summary estimates of the effectiveness of each type of intervention. All interventions reduced diarrhoea morbidity, with pooled risk ratios ranging from 0.98 to 0.51 (where a risk ratio of 1.0 indicates no effect and lower risk ratios indicate stronger effects). The removal of poor quality studies from the analyses improved the strength of the intervention impact in most cases. The 95 percent confidence intervals (CIs) for the pooled risk ratios of various interventions overlapped, indicating their effects were not statistically significantly different from each other. 2013-06-04T20:10:19Z 2013-06-04T20:10:19Z 2004-07-01 http://documents.worldbank.org/curated/en/2004/07/6566654/water-sanitation-hygiene-interventions-diarrhoea-systematic-review-meta-analysis http://hdl.handle.net/10986/13742 English en_US HNP discussion paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	ADEQUATE SANITATION AGED ANIMAL EXCRETA BASIC SANITATION BASIC WATER SUPPLY CHILD MORTALITY CHOLERA CONTAMINANTS DIARRHEAL DISEASES DISEASE RISK DRINKING WATER DRINKING WATER SUPPLY DYSENTERY EPIDEMIOLOGY EXCRETA DISPOSAL GROUND WATER HAND PUMP HEALTH EDUCATION HOUSEHOLD CONNECTION HOUSEHOLD CONNECTIONS HUMAN EXCRETA HUMAN FAECES HYGIENE HYGIENE BEHAVIOURS HYGIENE EDUCATION HYGIENE PRACTICES HYGIENE PROMOTION HYGIENIC BEHAVIOUR INADEQUATE WATER INADEQUATE WATER SUPPLY INCIDENCE OF DIARRHOEA INFECTIOUS DISEASES INTERVENTION MORBIDITY NUTRITION PIT LATRINE PROVISION OF SERVICES PROVISION OF WATER PUBLIC HEALTH PUBLIC STANDPIPE QUALITY RAINWATER COLLECTION RIVERS SAFE WATER SANITATION SANITATION FACILITIES SANITATION SERVICES SANITATION SITUATION SANITATION WATER SANITATION WATER SUPPLY SURFACE WATER USE OF WATER WASHING WASTE WATER WATER WATER CONSUMPTION WATER QUALITY WATER QUANTITY WATER SECTOR WATER SOURCE WATER SUPPLIES WATER SUPPLY WATER TANKER WATER TREATMENT
spellingShingle	ADEQUATE SANITATION AGED ANIMAL EXCRETA BASIC SANITATION BASIC WATER SUPPLY CHILD MORTALITY CHOLERA CONTAMINANTS DIARRHEAL DISEASES DISEASE RISK DRINKING WATER DRINKING WATER SUPPLY DYSENTERY EPIDEMIOLOGY EXCRETA DISPOSAL GROUND WATER HAND PUMP HEALTH EDUCATION HOUSEHOLD CONNECTION HOUSEHOLD CONNECTIONS HUMAN EXCRETA HUMAN FAECES HYGIENE HYGIENE BEHAVIOURS HYGIENE EDUCATION HYGIENE PRACTICES HYGIENE PROMOTION HYGIENIC BEHAVIOUR INADEQUATE WATER INADEQUATE WATER SUPPLY INCIDENCE OF DIARRHOEA INFECTIOUS DISEASES INTERVENTION MORBIDITY NUTRITION PIT LATRINE PROVISION OF SERVICES PROVISION OF WATER PUBLIC HEALTH PUBLIC STANDPIPE QUALITY RAINWATER COLLECTION RIVERS SAFE WATER SANITATION SANITATION FACILITIES SANITATION SERVICES SANITATION SITUATION SANITATION WATER SANITATION WATER SUPPLY SURFACE WATER USE OF WATER WASHING WASTE WATER WATER WATER CONSUMPTION WATER QUALITY WATER QUANTITY WATER SECTOR WATER SOURCE WATER SUPPLIES WATER SUPPLY WATER TANKER WATER TREATMENT Fewtrell, Lorna Colford, John M. Jr. Water, Sanitation and Hygiene : Interventions and Diarrhoea
relation	HNP discussion paper;
description	Many individual studies have reported results of interventions intended to reduce illness through improvements in drinking water, sanitation facilities and hygiene practices. This paper provides a formal systematic review and meta-analysis examining the evidence of the effectiveness of these interventions. Through a comprehensive literature search and bibliographic review, 2120 titles published prior to June 26th, 2003 were screened, 336 papers were obtained for a more thorough examination, and 64 of these papers (representing 60 distinct studies) were identified which detailed water supply, water quality, sanitation, hygiene or multifactorial interventions and examined diarrhoea morbidity as a health outcome in non-outbreak conditions. Data were extracted from these papers and pooled through meta-analysis to provide summary estimates of the effectiveness of each type of intervention. All interventions reduced diarrhoea morbidity, with pooled risk ratios ranging from 0.98 to 0.51 (where a risk ratio of 1.0 indicates no effect and lower risk ratios indicate stronger effects). The removal of poor quality studies from the analyses improved the strength of the intervention impact in most cases. The 95 percent confidence intervals (CIs) for the pooled risk ratios of various interventions overlapped, indicating their effects were not statistically significantly different from each other.
format	Publications & Research :: Working Paper
author	Fewtrell, Lorna Colford, John M. Jr.
author_facet	Fewtrell, Lorna Colford, John M. Jr.
author_sort	Fewtrell, Lorna
title	Water, Sanitation and Hygiene : Interventions and Diarrhoea
title_short	Water, Sanitation and Hygiene : Interventions and Diarrhoea
title_full	Water, Sanitation and Hygiene : Interventions and Diarrhoea
title_fullStr	Water, Sanitation and Hygiene : Interventions and Diarrhoea
title_full_unstemmed	Water, Sanitation and Hygiene : Interventions and Diarrhoea
title_sort	water, sanitation and hygiene : interventions and diarrhoea
publisher	World Bank, Washington, DC
publishDate	2013
url	http://documents.worldbank.org/curated/en/2004/07/6566654/water-sanitation-hygiene-interventions-diarrhoea-systematic-review-meta-analysis http://hdl.handle.net/10986/13742
_version_	1764424362327277568

Water, Sanitation and Hygiene : Interventions and Diarrhoea

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