Publication: Water, Sanitation and Hygiene : Interventions and Diarrhoea
Date
2004-07-01
ISSN
Published
2004-07-01
Author(s)
Fewtrell, Lorna
Colford, John M. Jr.
Abstract
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.
Citation
“Fewtrell, Lorna; Colford, John M. Jr.. 2004. Water, Sanitation and Hygiene : Interventions and Diarrhoea. HNP discussion paper;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/92d84492-3d00-5615-92fa-39030a97a724 License: CC BY 3.0 IGO.”