Interventions to improve disposal of human excreta for preventing diarrhoea

Abstract

This review provides some evidence that interventions to improve excreta disposal are effective in preventing diarrhoeal disease. However, this conclusion is based primarily on the consistency of the evidence of beneficial effects. The quality of the evidence is generally poor and does not allow for quantification of any such effect. The wide range of estimates of the effects of the intervention may be due to clinical and methodological heterogeneity among the studies, as well as to other important differences, including exposure levels, types of interventions, and different degrees of observer and respondent bias. Rigorous studies in multiple settings are needed to clarify the potential effectiveness of excreta disposal on diarrhoea.

Factors Contributing to Diarrheal Diseases among Children Less than Five Years in Nyarugenge District, Rwanda

“…Diarrhea is generally due to exposure to diarrhea-causing organisms which is mainly found in feaces. The practice of unsafe child feaces disposal contaminates the surrounding environment with human excreta which carries many infectious organisms that can cause enteric diseases such as childhood diarrhea [26][27][28]. This result was consistent with other reports, where environmental sanitations most often linked with the diarrhoea is refuse disposal [29][30][31].…”

“…In Ethiopia the prevalence of diarrheal disease among under-five children in a 2-week period was reported 31.0% in Arba Minch District [6], 26.1% in Hadaleala District [7], 24.9% in northwest Ethiopia [8], 22.5% in the eastern part of Ethiopia [9], 19.6% in a rural area of southern Ethiopia [10] and 18.0% in Mecha District [11]. There are different factors associated with occurrence of diarrhea among children less than five years and these differ from place to place.…”

Sanitation and Hygiene in Africa: Where do we Stand?

“…These include both interventions that directly provide 'hardware' for excreta disposal, through new or improved latrines or connection of existing latrines to the public sewer, and that provide the 'software' for hygienic practices, including hygiene and health education and the encouragement of specific behaviours such as hand washing with soap (Esrey et al 1991;Curtis & Cairncross, 2003;Fewtrell et al 2005;Clasen et al 2010).…”

“…1 But what does the evidence from Africa say? The most striking finding is a marked lack of high quality studies conducted in Africa for the effect of both sanitation and hygiene interventions on diarrhoea, as well as more generally (Clasen et al 2010). Figure 3.2 depicts results of the four studies we have been able to identify which measure the effect of latrines, hygiene promotion, or a combination of these, on diarrhoeal disease rates in Africa.…”

“…This review found few high quality interventions studies, with most studies included being ranked as poor quality, and the only randomised controlled trial being for point of use water treatment (Du Preez et al 2011). Partly in response to this lack of evidence, there are studies underway that, with the Humphrey study, will shed further light on this (Clasen et al 2010;Luby et al 2012).…”