wow-inequalities/02-data/intermediate/wos_sample/8d73575ad9f59f65ecbe54d5a22dcb2a-waddington-hugh-sha/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Author summary Why was this study done? The biggest contributor to the
global burden of infectious disease in childhood in developing countries
is mortality due to respiratory and diarrhoeal infections, both of which
are closely linked to deficient water, sanitation, and hygiene (WASH)
availability and use by households.Multiple systematic reviews and
meta-analyses of WASH-related morbidity have been conducted, but there
is a shortage of rigorous, systematic evidence on the effectiveness of
WASH interventions in reducing mortality. What did the researchers do
and find? We conducted a systematic review and meta-analysis of the
impacts of WASH interventions on all-cause and diarrhoea-related
mortality in L\&MICs, incorporating evidence from 35 studies comprising
48 distinct WASH intervention arms.We found significant effects on
all-cause mortality among children aged under 5 of interventions to
improve the quantity of water available (34\% reduction), hygiene
promotion when water supplies were accessible to households (29\%
reduction), and community-wide sanitation (21\% reduction).We also found
significant effects of WASH interventions on diarrhoea mortality among
under 5s (45\% reduction), which were significantly larger when provided
to communities that were at the lowest rungs of the sanitation ladder,
compared to those that already had improved WASH. What do these findings
mean? Interventions to prevent water-related mortality in childhood in
endemic disease circumstances provide adequate water supplies to
households, enabling domestic hygiene and safe excreta disposal in the
household and community.Systematic reviews can provide new evidence for
decision making, but the approach we present is reliant on trial authors
and journals adhering to agreed standards of reporting.
BackgroundIn low- and middle-income countries (L\&MICs), the biggest
contributing factors to the global burden of disease in childhood are
deaths due to respiratory illness and diarrhoea, both of which are
closely related to use of water, sanitation, and hygiene (WASH) services
by households. However, current estimates of the health impacts of WASH
interventions use self-reported morbidity, which may fail to capture
longer-term or more severe impacts. Reported mortality is thought to be
less prone to bias than other reported measures. This study aimed to
answer the question: What are the impacts of WASH interventions on
reported childhood mortality in L\&MICs? Methods and findingsWe
conducted a systematic review and meta-analysis, using a published
protocol. Systematic searches of 11 academic databases and trial
registries, plus organisational repositories, were undertaken to locate
studies of WASH interventions, which were published in peer review
journals or other sources (e.g., organisational reports and working
papers). Intervention studies of WASH improvements implemented under
endemic disease circumstances in L\&MICs were eligible, which reported
findings at any time until March 2020. We used the participant flow data
supplied in response to journal editors'' calls for greater transparency.
Data were collected by two authors working independently.We included
evidence from 24 randomized and 11 nonrandomized studies of WASH
interventions from all global regions, incorporating 2,600 deaths.
Effects of 48 WASH treatment arms were included in analysis. We
critically appraised and synthesised evidence using meta-analysis to
improve statistical power. We found WASH interventions are associated
with a significant reduction of 17\% in the odds of all-cause mortality
in childhood (OR = 0.83, 95\% CI = 0.74, 0.92, evidence from 38
interventions), and a significant reduction in diarrhoea mortality of
45\% (OR = 0.55, 95\% CI = 0.35, 0.84; 10 interventions).Further
analysis by WASH technology indicated interventions providing improved
water in quantity to households were most consistently associated with
reductions in all-cause mortality. Community-wide sanitation was most
consistently associated with reductions in diarrhoea mortality. Around
one-half of the included studies were assessed as being at ``moderate
risk of bias{''''} in attributing mortality in childhood to the WASH
intervention, and no studies were found to be at ``low risk of bias.{''''}
The review should be updated to incorporate additional published and
unpublished participant flow data. ConclusionsThe findings are congruent
with theories of infectious disease transmission. Washing with water
presents a barrier to respiratory illness and diarrhoea, which are the
two biggest contributors to all-cause mortality in childhood in L\&MICs.
Community-wide sanitation halts the spread of diarrhoea. We observed
that evidence synthesis can provide new findings, going beyond the
underlying data from trials to generate crucial insights for policy.
Transparent reporting in trials creates opportunities for research
synthesis to answer questions about mortality, which individual studies
of interventions cannot be reliably designed to address.'
affiliation: 'Waddington, HS (Corresponding Author), London Int Dev Ctr LIDC, London
Sch Hyg \& Trop Med LSHTM, Dept Dis Control, Environm Hlth Grp, London, England.
Waddington, Hugh Sharma, London Int Dev Ctr LIDC, London Sch Hyg \& Trop Med LSHTM,
Dept Dis Control, Environm Hlth Grp, London, England.
Masset, Edoardo, LSHTM, Ctr Excellence Dev Impact \& Learning CEDIL, LIDC, Dept
Publ Hlth Environm \& Soc, London, England.
Bick, Sarah; Cairncross, Sandy, LSHTM, Dept Dis Control, Environm Hlth Grp, London,
England.'
article-number: e1004215
author: Waddington, Hugh Sharma and Masset, Edoardo and Bick, Sarah and Cairncross,
Sandy
author-email: Hugh.waddington@lshtm.ac.uk
author_list:
- family: Waddington
given: Hugh Sharma
- family: Masset
given: Edoardo
- family: Bick
given: Sarah
- family: Cairncross
given: Sandy
da: '2023-09-28'
doi: 10.1371/journal.pmed.1004215
eissn: 1549-1676
files: []
issn: 1549-1277
journal: PLOS MEDICINE
keywords-plus: 'DIARRHEAL DISEASE; NUTRITIONAL INTERVENTIONS; SOLAR DISINFECTION;
CONTROLLED-TRIALS; INFANT-MORTALITY; RANDOMIZED-TRIAL; YOUNG-CHILDREN;
WESTERN KENYA; HEALTH; GROWTH'
language: English
month: APR
number: '4'
number-of-cited-references: '106'
orcid-numbers: 'Sharma Waddington, Hugh/0000-0003-3859-3342
Bick, Sarah/0000-0001-6870-5320
Masset, Edoardo/0000-0002-8826-0776'
papis_id: 27bdb30ce5f9f747bd99a903cea5aedd
ref: Waddington2023impactchildhood
tags:
- review
times-cited: '1'
title: 'Impact on childhood mortality of interventions to improve drinking water,
sanitation, and hygiene (WASH) to households: Systematic review and meta-analysis'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000971493100001
usage-count-last-180-days: '8'
usage-count-since-2013: '8'
volume: '20'
web-of-science-categories: Medicine, General \& Internal
year: '2023'