Water, sanitation and hygiene interventions for acute childhood diarrhea: a systematic review to provide estimates for the Lives Saved Tool

Darvesh, Nazia; Das, Jai K; Vaivada, Tyler; Gaffey, Michelle F; Rasanathan, Kumanan; Bhutta, Zulfiqar A

doi:10.1186/s12889-017-4746-1

Cited by 106 publications

(112 citation statements)

References 52 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…Household water, sanitation, and hygiene (WASH) interventions have been suggested as keys in combating enteric pathogen transmission and infections [(16, 35, 36)]. While we found some domestic food hygiene risk factors were associated with enteric pathogen presence and diversity in bivariate analysis, most of these associations reduced in magnitude and did not improve model fit after adjustment for food type.…”

Section: Discussioncontrasting

confidence: 65%

Enteric Pathogen Diversity in Infant Foods in Low-income Neighborhoods Of Kisumu, Kenya

Tsai

Simiyu

Mumma

et al. 2018

Preprint

View full text Add to dashboard Cite

23Pediatric diarrheal disease remains the 2nd most common cause of preventable illness 24 and death among children under the age of five, especially in Low and Middle-Income Countries 25 (LMICs). However, there is limited information regarding the role of food in pathogen 26 transmission due to measuring infant food contaminations in LMICs. For this study, we 27 examined the frequency of enteric pathogen occurrence and co-occurrence in 127 weaning infant 28 foods in Kisumu, Kenya using a multi-pathogen rt-PCR diagnostic tool, and assessed household 29 food hygiene risk factors for contamination. Bacterial, viral, and protozoa enteric pathogen DNA 30 and RNA were detected in 62% of the infant weaning food samples collected, with 37% of foods 31 containing more than one pathogen type. Multivariable generalized linear mixed model analysis 32 indicated type of infant food best explained the presence and diversity of enteric pathogens in 33 infant food, while most household food hygiene risk factors considered in this study were not 34 significantly associated with pathogen contamination. Specifically, cow's milk was significantly 35 more likely to contain a pathogen (adjusted Risk Ratio=14.4; 95% Confidence Interval (CI) 1.78-36 116.1) and contained 2.35 more types of pathogens (adjusted Risk Ratio=2.35; 95% CI 1.67-37 3.29) than porridge. Our study demonstrates that infants in this low-income urban setting are 38 frequently exposed to diarrhoeagenic pathogens in food and suggests that interventions are 39 needed to prevent foodborne transmission of pathogens to infants. 40 41 Importance. 42Food is acknowledged as an important pathway for enteric pathogen infection in young 43children. Yet, information on enteric pathogen contamination in food in low-and-middle income 44 settings is lacking, especially with respect to weaning foods given to young infants. This study 45Page 3 of 37 assessed which food-related risk factors were associated with increased presence of and diversity 46 in twenty-seven types of enteric pathogens in a variety of foods provided to infants between 47 three and nine months of age in a low-income neighborhood of Kisumu, Kenya. Feeding infants 48 cow milk emerged as the most important risk factor for food contamination by one or more 49 enteric pathogens. The results indicate public health interventions should focus on improving 50 cow milk safety to prevent foodborne pathogen transmission to infants. However, more research 51 is needed to determine whether infant milk contamination was caused by caregiver hygiene 52 practices versus food contamination passed from upstream sources. 53 54 Introduction. 55

show abstract

Section: Discussioncontrasting

confidence: 65%

Enteric Pathogen Diversity in Infant Foods in Low-income Neighborhoods Of Kisumu, Kenya

Tsai

Simiyu

Mumma

et al. 2018

Preprint

View full text Add to dashboard Cite

show abstract

“…20 In addition, hand washing can reduce the occurrence of diarrheal diseases by 14-40%, 10,21,22 and educating mothers about personal hygiene can lead to a 27% decrease in the risk of infectious disease. 23 Mothers are the immediate and reliable caregivers of children in many countries, and they play a central role in childrens health. 24,25 Mothers' knowledge, attitudes, and practices have a significant effect on the maintenance of child health.…”

Section: Introductionmentioning

confidence: 99%

<p>Mother’s Handwashing Practices and Health Outcomes of Under-Five Children in Northwest Ethiopia</p>

Taddese

Dagnew

Andualem

2020

PHMT

View full text Add to dashboard Cite

Background: Improving handwashing practices of mothers is important in developing countries to reduce child morbidity, mortality, and hygiene-related illnesses. This study aimed to assess mothers handwashing practice and the health effects on under-five children in northwest Ethiopia. Methods: The study was an institution-based cross-sectional study conducted from November 2018 to January 2019 at the University of Gondar comprehensive specialized hospital. Four hundred and twenty two randomly selected mothers who have had under-five children were included in the study. Structured questioners were developed to assess handwashing practics and sociodemographic characterististics of mothers, and medical history related data of children were extracted from medical charts. Data entry and clearance were performed by Epi-info TM version-7 software and exported for analysis to SPSS 22. Adjusted odds ratio with a 95% confidence interval was used to declare statistically significant variables on the basis of p-value < 0.05. Results: The proportion of mothers who practiced good handwashing was 39.1% [95% CI: (34.8-43.9)]. More than half (54.3% and 53.6%) of the mothers indicated that they always remind their children to wash their hands before and after eating, respectively. However, 28% of under-five children were admitted to hospital with a diarrheal disease which may have been due to the poor hand washing practices of their mother. The odds of having good knowledge of handwashing practices were 0.26 times lower. Being married increased the handwashing practices of mothers by 2.62 times. Conclusion: The majority of mothers who were knowledgable about handwashing were not executing it accuractely. Diarrheal admissions among under-five children have been influenced by their mother's poor hand washing practices. Therefore, it is imperitive to improve the understanding of proper handwashing practices of mothers at every level in the community.

show abstract

“…One likely relevant study was excluded because it was published in Portuguese [91]. One eligible review found only one study [55]; we did not include this article in our analysis as it is not clear why the authors did not find a number of eligible studies that were found in earlier reviews [92]. After searching the references of the 10 identified literature reviews, three additional reviews were identified resulting in a total of 13 literature reviews on the relationship between sanitation and diarrhea [13,14,18].…”

Section: Resultsmentioning

confidence: 99%

Does Basic Sanitation Prevent Diarrhea? Contextualizing Recent Intervention Trials through a Historical Lens

Contreras

Eisenberg

2019

IJERPH

View full text Add to dashboard Cite

Three of four recent major sanitation intervention trials found no effect on diarrhea. These results conflicted with longstanding beliefs from decades of literature. To understand this discordance, we placed recent trials into the historical context that preceded them in two ways. First, we evaluated the history of published literature reviews on sanitation and diarrhea. Second, we conducted meta-analyses on studies from the most recent systematic review to uncover features that predict effectiveness. We found that 13 literature reviews dating to 1983 consistently estimated a significant protective effect of sanitation against diarrhea. However, these were marred by flawed studies and inappropriately averaged effects across widely heterogeneous interventions and contexts. Our meta-analyses highlight that the overall effect of sanitation on diarrhea was largely driven by sewerage and interventions that improved more than sanitation alone. There is no true overall effect of sanitation because variability between intervention types and implementation contexts is too complex to average. Ultimately, the null effects of recent latrine interventions are not surprising. Instead, the one trial that found a strong relative reduction in diarrhea is the historical outlier. The development of transformative sanitation interventions requires a better understanding of the social and environmental contexts that determine intervention effectiveness.

show abstract

Water, sanitation and hygiene interventions for acute childhood diarrhea: a systematic review to provide estimates for the Lives Saved Tool

Cited by 106 publications

References 52 publications

Enteric Pathogen Diversity in Infant Foods in Low-income Neighborhoods Of Kisumu, Kenya

Enteric Pathogen Diversity in Infant Foods in Low-income Neighborhoods Of Kisumu, Kenya

<p>Mother’s Handwashing Practices and Health Outcomes of Under-Five Children in Northwest Ethiopia</p>

Does Basic Sanitation Prevent Diarrhea? Contextualizing Recent Intervention Trials through a Historical Lens

Contact Info

Product

Resources

About