The Childhood Health Effects of an Improved Water Supply System on a Remote Panamanian Island

Rw, Ryder; Wc, Reeves; Singh, Neelu; Cb, Hall; Az, Kapikian; Gómez, Beatriz; Rb, Sack

doi:10.4269/ajtmh.1985.34.921

Cited by 21 publications

(30 citation statements)

References 5 publications

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“…In rural Alaska, one rigorous study found that skin infections decreased by 20% (95% CI: 10-30%, p=0.003) across four villages after installation of on-plot water access (Thomas et al, 2016). A less rigorous study conducted in Panama found that incidence of impetigo and scabies was significantly lower among children from households with on-plot water than from households collecting water from a stream (p<0.05); however, the study analysis did not account for confounders (Ryder et al, 1985).…”

Section: Height Weight and Weight-for-heightmentioning

confidence: 97%

“…One rigorous study reported that respiratory infections significantly decreased across four villages after installation of piped water access (16%, 95% CI: 11-21%, p<0.0001) (Thomas et al, 2016). Risk of respiratory infection was not significantly different between households with and without on-plot access in a second rigorous study (OR=0.64, 95% CI: 0.37-1.12, p=0.117) (Bulkow et al, 2012) and two less rigorous studies (Ryder et al, 1985;Singleton et al, 2003). In two studies reporting no effect, cases were defined by hospitalization with respiratory disease, and were found to be statistically more likely to be premature (Bulkow et al, 2012;Singleton et al, 2003) or high-risk infants (Bulkow et al, 2012), which could limit comparability between case and control status.…”

Section: Height Weight and Weight-for-heightmentioning

confidence: 98%

“…Eight studies reported multiple health outcomes included in the review (Checkley et al, 2004;Henry, 1981;Mason et al, 1986;Mukalay et al, 2010;Rajasekaran et al, 1977;Ryder et al, 1985;Thomas et al, 2016;Wang et al, 1989). Study design varied across health outcomes (Table 3).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…On-plot water access was not associated with prevalence of campylobacteriosis among children (Molbak et al, 1988) or household dysentery incidence (Wang et al, 1989). In two of the less rigorous studies not reporting a health benefit, children from households with on-plot water sources had significantly higher giardiasis and diarrhea prevalence than children from households using shared sources (p<0.001, p<0.05), but the statistical analyses were conducted by chisquared tests and did not account for factors such as sanitation, hygiene, water source type, and water quality (Ryder et al, 1985;Mason et al, 1986).…”

Section: Diarrheal Diseasesmentioning

confidence: 99%

“…Quantity of water use was estimated by metered water use (Brown et al, 2013;Thomas et al, 2016), user estimates (Brown et al, 2013;Schemann et al, 2002), household logs (Thomas et al, 2016), number of filled containers (Henry, 1981), or unreported methods (Devoto et al, 2011;Ryder et al, 1985). Five studies found that households with on-plot water supplies used greater quantities of water (Brown et al, 2013;Henry, 1981;Ryder et al, 1985;Thomas et al, 2016) and greater quantities for hygiene (Devoto et al, 2011). An inverse relationship between distance to source and quantity of water used was reported in Mali (Schemann et al, 2002).…”

Section: Water Quantity Storage and Reliabilitymentioning

confidence: 99%

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On-plot drinking water supplies and health: A systematic review

Overbo

Williams

Evans

et al. 2016

International Journal of Hygiene and Environmental Health

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Many studies have found that household access to water supplies near or within the household plot can reduce the probability of diarrhea, trachoma, and other water-related diseases, and it is generally accepted that on-plot water supplies produce health benefits for households. However, the body of research literature has not been analyzed to weigh the evidence supporting this. A systematic review was conducted to investigate the impacts of on-plot water supplies on diarrhea, trachoma, child growth, and water-related diseases, to further examine the relationship between household health and distance to water source and to assess whether on-plot water supplies generate health gains for households. Studies provide evidence that households with on-plot water supplies experience fewer diarrheal and helminth infections and greater child height. Findings suggest that water-washed (hygiene associated) diseases are more strongly impacted by on-plot water access than waterborne diseases. Few studies analyzed the effects of on-plot water access on quantity of domestic water used, hygiene behavior, and use of multiple water sources, and the lack of evidence for these relationships reveals an important gap in current literature. The review findings indicate that on-plot water access is a useful health indicator and benchmark for the progressive realization of the Sustainable Development Goal target of universal safe water access as well as the human right to safe water.

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Section: Height Weight and Weight-for-heightmentioning

confidence: 97%

Section: Height Weight and Weight-for-heightmentioning

confidence: 98%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Diarrheal Diseasesmentioning

confidence: 99%

Section: Water Quantity Storage and Reliabilitymentioning

confidence: 99%

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On-plot drinking water supplies and health: A systematic review

Overbo

Williams

Evans

et al. 2016

International Journal of Hygiene and Environmental Health

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PROTOCOL: Water, sanitation and hygiene for reducing childhood mortality in low‐ and middle‐income countries

Waddington

Cairncross

2021

Campbell Systematic Reviews

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Respiratory tract infections and diarrhoea are the two biggest killers of children in low income contexts. They are closely related to access to, and use of improved water, sanitation and hygiene (WASH). However, there is no high quality systematic review that quantifies the effect of WASH improvements on childhood mortality. Existing systematic reviews of WASH improvements measure effects on morbidity, under the (often implicit) assumption that morbidity is closely correlated with mortality. This is at least partly because the impact evaluations on which they are based are only designed to detect changes in morbidity with statistical precision, whereas mortality is a relatively rare outcome. The proposed review will address this evidence synthesis gap, using the greater statistical power of meta‐analysis to pool findings across studies.

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Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low‐ and middle‐income countries: An evidence and gap map of effectiveness studies

Chirgwin

Cairncross

Zehra

et al. 2021

Campbell Systematic Reviews

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Background Lack of access to and use of water, sanitation and hygiene (WASH) cause 1.6 million deaths every year, of which 1.2 million are due to gastrointestinal illnesses like diarrhoea and acute respiratory infections like pneumonia. Poor WASH access and use also diminish nutrition and educational attainment, and cause danger and stress for vulnerable populations, especially for women and girls. The hardest hit regions are sub‐Saharan Africa and South Asia. Sustainable Development Goal (SDG) 6 calls for the end of open defecation, and universal access to safely managed water and sanitation facilities, and basic hand hygiene, by 2030. WASH access and use also underpin progress in other areas such as SDG1 poverty targets, SDG3 health and SDG4 education targets. Meeting the SDG equity agenda to “leave none behind” will require WASH providers prioritise the hardest to reach including those living remotely and people who are disadvantaged. Objectives Decision makers need access to high‐quality evidence on what works in WASH promotion in different contexts, and for different groups of people, to reach the most disadvantaged populations and thereby achieve universal targets. The WASH evidence map is envisioned as a tool for commissioners and researchers to identify existing studies to fill synthesis gaps, as well as helping to prioritise new studies where there are gaps in knowledge. It also supports policymakers and practitioners to navigate the evidence base, including presenting critically appraised findings from existing systematic reviews. Methods This evidence map presents impact evaluations and systematic reviews from the WASH sector, organised according to the types of intervention mechanisms, WASH technologies promoted, and outcomes measured. It is based on a framework of intervention mechanisms (e.g., behaviour change triggering or microloans) and outcomes along the causal pathway, specifically behavioural outcomes (e.g., handwashing and food hygiene practices), ill‐health outcomes (e.g., diarrhoeal morbidity and mortality), nutrition and socioeconomic outcomes (e.g., school absenteeism and household income). The map also provides filters to examine the evidence for a particular WASH technology (e.g., latrines), place of use (e.g., home, school or health facility), location (e.g., global region, country, rural and urban) and group (e.g., people living with disability). Systematic searches for published and unpublished literature and trial registries were conducted of studies in low‐ and middle‐income countries (LMICs). Searches were conducted in March 2018, and searches for completed trials were done in May 2020. Coding of information for the map was done by two authors working independently. Impact evaluations were critically appraised according to methods of conduct and reporting. Systematic reviews were critically appraised using a new approach to assess theory‐based, mixed‐methods evidence synthesis. Results There has been an enormous growth in impact evaluations and systematic reviews of WASH ...

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The Childhood Health Effects of an Improved Water Supply System on a Remote Panamanian Island

Abstract: The incidence of diarrhea, respiratory disease, and skin infections was pro

Cited by 21 publications

References 5 publications

On-plot drinking water supplies and health: A systematic review

On-plot drinking water supplies and health: A systematic review

PROTOCOL: Water, sanitation and hygiene for reducing childhood mortality in low‐ and middle‐income countries

Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low‐ and middle‐income countries: An evidence and gap map of effectiveness studies

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