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Water, sanitation and hygiene for the prevention of diarrhoea
Background Ever since John Snow’s intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality....
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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Oxford University Press
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845874/ https://www.ncbi.nlm.nih.gov/pubmed/20348121 http://dx.doi.org/10.1093/ije/dyq035 |
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author | Cairncross, Sandy Hunt, Caroline Boisson, Sophie Bostoen, Kristof Curtis, Val Fung, Isaac CH Schmidt, Wolf-Peter |
author_facet | Cairncross, Sandy Hunt, Caroline Boisson, Sophie Bostoen, Kristof Curtis, Val Fung, Isaac CH Schmidt, Wolf-Peter |
author_sort | Cairncross, Sandy |
collection | PubMed |
description | Background Ever since John Snow’s intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality. Methods We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate. Results The striking effect of handwashing with soap is consistent across various study designs and pathogens, though it depends on access to water. The effect of water treatment appears similarly large, but is not found in few blinded studies, suggesting that it may be partly due to the placebo effect. There is very little rigorous evidence for the health benefit of sanitation; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese. Conclusion We propose diarrhoea risk reductions of 48, 17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the LiST model. Most of the evidence is of poor quality. More trials are needed, but the evidence is nonetheless strong enough to support the provision of water supply, sanitation and hygiene for all. |
format | Text |
id | pubmed-2845874 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-28458742010-03-29 Water, sanitation and hygiene for the prevention of diarrhoea Cairncross, Sandy Hunt, Caroline Boisson, Sophie Bostoen, Kristof Curtis, Val Fung, Isaac CH Schmidt, Wolf-Peter Int J Epidemiol Articles Background Ever since John Snow’s intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality. Methods We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate. Results The striking effect of handwashing with soap is consistent across various study designs and pathogens, though it depends on access to water. The effect of water treatment appears similarly large, but is not found in few blinded studies, suggesting that it may be partly due to the placebo effect. There is very little rigorous evidence for the health benefit of sanitation; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese. Conclusion We propose diarrhoea risk reductions of 48, 17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the LiST model. Most of the evidence is of poor quality. More trials are needed, but the evidence is nonetheless strong enough to support the provision of water supply, sanitation and hygiene for all. Oxford University Press 2010-04 2010-03-23 /pmc/articles/PMC2845874/ /pubmed/20348121 http://dx.doi.org/10.1093/ije/dyq035 Text en Published by Oxford University Press on behalf of the International Epidemiological Association. © The Author 2010; all rights reserved. http://creativecommons.org/licenses/by-nc/2.5/uk/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Articles Cairncross, Sandy Hunt, Caroline Boisson, Sophie Bostoen, Kristof Curtis, Val Fung, Isaac CH Schmidt, Wolf-Peter Water, sanitation and hygiene for the prevention of diarrhoea |
title | Water, sanitation and hygiene for the prevention of diarrhoea |
title_full | Water, sanitation and hygiene for the prevention of diarrhoea |
title_fullStr | Water, sanitation and hygiene for the prevention of diarrhoea |
title_full_unstemmed | Water, sanitation and hygiene for the prevention of diarrhoea |
title_short | Water, sanitation and hygiene for the prevention of diarrhoea |
title_sort | water, sanitation and hygiene for the prevention of diarrhoea |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845874/ https://www.ncbi.nlm.nih.gov/pubmed/20348121 http://dx.doi.org/10.1093/ije/dyq035 |
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