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      Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis.

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          Abstract

          Preventive chemotherapy represents a powerful but short-term control strategy for soil-transmitted helminthiasis. Since humans are often re-infected rapidly, long-term solutions require improvements in water, sanitation, and hygiene (WASH). The purpose of this study was to quantitatively summarize the relationship between WASH access or practices and soil-transmitted helminth (STH) infection.

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          Water, sanitation and hygiene for the prevention of diarrhoea

          Sandy Cairncross, Caroline Hunt, Sophie Boisson … (2010)
          Background Ever since John Snow’s intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality. Methods We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate. Results The striking effect of handwashing with soap is consistent across various study designs and pathogens, though it depends on access to water. The effect of water treatment appears similarly large, but is not found in few blinded studies, suggesting that it may be partly due to the placebo effect. There is very little rigorous evidence for the health benefit of sanitation; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese. Conclusion We propose diarrhoea risk reductions of 48, 17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the LiST model. Most of the evidence is of poor quality. More trials are needed, but the evidence is nonetheless strong enough to support the provision of water supply, sanitation and hygiene for all.
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            Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution.

            J Utzinger, G. Raso, S. Brooker … (2009)
            In May 2001, the World Health Assembly (WHA) passed a resolution which urged member states to attain, by 2010, a minimum target of regularly administering anthelminthic drugs to at least 75% and up to 100% of all school-aged children at risk of morbidity. The refined global strategy for the prevention and control of schistosomiasis and soil-transmitted helminthiasis was issued in the following year and large-scale administration of anthelminthic drugs endorsed as the central feature. This strategy has subsequently been termed 'preventive chemotherapy'. Clearly, the 2001 WHA resolution led the way for concurrently controlling multiple neglected tropical diseases. In this paper, we recall the schistosomiasis situation in Africa in mid-2003. Adhering to strategic guidelines issued by the World Health Organization, we estimate the projected annual treatment needs with praziquantel among the school-aged population and critically discuss these estimates. The important role of geospatial tools for disease risk mapping, surveillance and predictions for resource allocation is emphasised. We clarify that schistosomiasis is only one of many neglected tropical diseases and that considerable uncertainties remain regarding global burden estimates. We examine new control initiatives targeting schistosomiasis and other tropical diseases that are often neglected. The prospect and challenges of integrated control are discussed and the need for combining biomedical, educational and engineering strategies and geospatial tools for sustainable disease control are highlighted. We conclude that, for achieving integrated and sustainable control of neglected tropical diseases, a set of interventions must be tailored to a given endemic setting and fine-tuned over time in response to the changing nature and impact of control. Consequently, besides the environment, the prevailing demographic, health and social systems contexts need to be considered.
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              When can odds ratios mislead?

              Iain Crombie, M Tavakoli, Abigail H. Davies (1998)
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                Author and article information

                Journal
                Journal ID (iso-abbrev): PLoS Med.
                Title: PLoS medicine
                Publisher: Public Library of Science (PLoS)
                ISSN (Electronic): 1549-1676
                ISSN (Print): 1549-1277
                Publication date (Electronic): Mar 2014
                Volume: 11
                Issue: 3
                Affiliations
                [1 ] Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America.
                [2 ] Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
                [3 ] Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America; International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, United States of America.
                [4 ] Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
                Article
                Publisher Item ID: PMEDICINE-D-13-02702
                DOI: 10.1371/journal.pmed.1001620
                PMC ID: 3965411
                PubMed ID: 24667810
                SO-VID: 6d1fb055-d42d-4e48-a7f5-3b721bb843bc
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