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Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis
BACKGROUND: Under nutrition is linked with poor water, sanitation and hygiene (WASH) condition. However, there is conflicting evidence on the effect of WASH on nutritional status of children. This review was, therefore, conducted to estimate the pooled effect of WASH interventions on child under nut...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610930/ https://www.ncbi.nlm.nih.gov/pubmed/31272479 http://dx.doi.org/10.1186/s13052-019-0666-2 |
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author | Gizaw, Zemichael Worku, Alemayehu |
author_facet | Gizaw, Zemichael Worku, Alemayehu |
author_sort | Gizaw, Zemichael |
collection | PubMed |
description | BACKGROUND: Under nutrition is linked with poor water, sanitation and hygiene (WASH) condition. However, there is conflicting evidence on the effect of WASH on nutritional status of children. This review was, therefore, conducted to estimate the pooled effect of WASH interventions on child under nutrition. METHODS: All published and unpublished cluster-randomized, non-randomized controlled trials, and before and after intervention studies conducted in developing countries were included. Relevant articles were searched from MEDLINE/PubMed, Cochrane Collaboration’s database, Web of Science, WHO Global Health Library, Google Scholar, Worldcat and ProQuest electronic databases. The methodological quality of the included studies was assessed using JBI critical appraisal checklist for randomized and non-randomized controlled trials. The risk of bias was assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials. The treatment effect was expressed as standardized mean differences (SMD) with 95% confidence interval (CI). RESULTS: This meta-analysis of 10 studies including 16,473 children (7776 in the intervention and 8687 in the control group) indicated that WASH interventions significantly associated with increased pooled mean height-for-age-z-score (SMD = 0.14, 95% CI = (0.09, 0.19); I(2) = 39.3%]. The effect of WASH on HAZ was heterogeneous in age and types of interventions. WASH intervention had more effect on HAZ among under two children [SMD = 0.20, 95% CI = (0.11, 0.29); I(2) = 37%]. Children who received combined WASH interventions grew better compared with children who received single interventions [SMD = 0.15, 95% CI = (0.09, 0.20); I(2) = 43.8%]. CONCLUSION: WASH interventions were significantly associated with increased mean height-for-age-z score in under 5 years old children. The effect of WASH on linear growth is markedly different with age and types of interventions, either single or combined. Implementing combined WASH interventions has a paramount benefit to improve nutritional status of children. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13052-019-0666-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6610930 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66109302019-07-16 Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis Gizaw, Zemichael Worku, Alemayehu Ital J Pediatr Review BACKGROUND: Under nutrition is linked with poor water, sanitation and hygiene (WASH) condition. However, there is conflicting evidence on the effect of WASH on nutritional status of children. This review was, therefore, conducted to estimate the pooled effect of WASH interventions on child under nutrition. METHODS: All published and unpublished cluster-randomized, non-randomized controlled trials, and before and after intervention studies conducted in developing countries were included. Relevant articles were searched from MEDLINE/PubMed, Cochrane Collaboration’s database, Web of Science, WHO Global Health Library, Google Scholar, Worldcat and ProQuest electronic databases. The methodological quality of the included studies was assessed using JBI critical appraisal checklist for randomized and non-randomized controlled trials. The risk of bias was assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials. The treatment effect was expressed as standardized mean differences (SMD) with 95% confidence interval (CI). RESULTS: This meta-analysis of 10 studies including 16,473 children (7776 in the intervention and 8687 in the control group) indicated that WASH interventions significantly associated with increased pooled mean height-for-age-z-score (SMD = 0.14, 95% CI = (0.09, 0.19); I(2) = 39.3%]. The effect of WASH on HAZ was heterogeneous in age and types of interventions. WASH intervention had more effect on HAZ among under two children [SMD = 0.20, 95% CI = (0.11, 0.29); I(2) = 37%]. Children who received combined WASH interventions grew better compared with children who received single interventions [SMD = 0.15, 95% CI = (0.09, 0.20); I(2) = 43.8%]. CONCLUSION: WASH interventions were significantly associated with increased mean height-for-age-z score in under 5 years old children. The effect of WASH on linear growth is markedly different with age and types of interventions, either single or combined. Implementing combined WASH interventions has a paramount benefit to improve nutritional status of children. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13052-019-0666-2) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-04 /pmc/articles/PMC6610930/ /pubmed/31272479 http://dx.doi.org/10.1186/s13052-019-0666-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review Gizaw, Zemichael Worku, Alemayehu Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis |
title | Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis |
title_full | Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis |
title_fullStr | Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis |
title_full_unstemmed | Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis |
title_short | Effects of single and combined water, sanitation and hygiene (WASH) interventions on nutritional status of children: a systematic review and meta-analysis |
title_sort | effects of single and combined water, sanitation and hygiene (wash) interventions on nutritional status of children: a systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610930/ https://www.ncbi.nlm.nih.gov/pubmed/31272479 http://dx.doi.org/10.1186/s13052-019-0666-2 |
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