Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis

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dc.contributor.author Kay, David
dc.contributor.author Kaufmann, R. B.
dc.contributor.author Enanoria, W.
dc.contributor.author Fewtrell, Lorna
dc.date.accessioned 2010-12-20T14:52:01Z
dc.date.available 2010-12-20T14:52:01Z
dc.date.issued 2005-01
dc.identifier.citation Kay , D , Kaufmann , R B , Enanoria , W & Fewtrell , L 2005 , ' Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis ' Lancet Infectious Diseases , vol 5 , no. 1 , pp. 42-52 . en
dc.identifier.issn 1473-3099
dc.identifier.other PURE: 155908
dc.identifier.other dspace: 2160/6034
dc.identifier.uri http://hdl.handle.net/2160/6034
dc.description Kay, D., Fewtrell, L., Kaufman, R.B., Enanoria, W., (2005) 'Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis', Lancet Infectious Diseases 5(1) pp.42-52 RAE2008 en
dc.description.abstract Many studies have reported the results of interventions to reduce illness through improvements in drinking water, sanitation facilities, and hygiene practices in less developed countries. There has, however, been no formal systematic review and meta-analysis comparing the evidence of the relative effectiveness of these interventions. We developed a comprehensive search strategy designed to identify all peer-reviewed articles, in any language, that presented water, sanitation, or hygiene interventions. We examined only those articles with specific measurement of diarrhoea morbidity as a health outcome in non-outbreak conditions. We screened the titles and, where necessary, the abstracts of 2120 publications. 46 studies were judged to contain relevant evidence and were reviewed in detail. Data were extracted from these studies and pooled by meta-analysis to provide summary estimates of the effectiveness of each type of intervention. All of the interventions studied were found to reduce significantly the risks of diarrhoeal illness. Most of the interventions had a similar degree of impact on diarrhoeal illness, with the relative risk estimates from the overall meta-analyses ranging between 0·63 and 0·75. The results generally agree with those from previous reviews, but water quality interventions (point-of-use water treatment) were found to be more effective than previously thought, and multiple interventions (consisting of combined water, sanitation, and hygiene measures) were not more effective than interventions with a single focus. There is some evidence of publication bias in the findings from the hygiene and water treatment interventions. en
dc.format.extent 11 en
dc.language.iso eng
dc.relation.ispartof Lancet Infectious Diseases en
dc.title Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis en
dc.type Text en
dc.type.publicationtype Article (Journal) en
dc.identifier.doi http://dx.doi.org/10.1016/S1473-3099(04)01253-8
dc.contributor.institution Institute of Geography & Earth Sciences en
dc.contributor.institution River Basin Dynamics and Hydrology en
dc.description.status Peer reviewed en


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