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 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.

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Bibliographic Details
Main Authors: Fewtrell, Lorna, Colford, John M. Jr.
Format: Working Paper biblioteca
Language:English
en_US
Published: World Bank, Washington, DC 2004-07-01
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
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