Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries.
Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries.
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DOI：
10.1111/tmi.12329
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Cairncross S
中科院分区：
文献类型：
--
作者：
Prüss-Ustün A;Bartram J;Clasen T;Colford JM Jr;Cumming O;Curtis V;Bonjour S;Dangour AD;De France J;Fewtrell L;Freeman MC;Gordon B;Hunter PR;Johnston RB;Mathers C;Mäusezahl D;Medlicott K;Neira M;Stocks M;Wolf J;Cairncross S
估计低收入和中等收入环境中因水、环境卫生和手部卫生不足而造成的肠道疾病负担，并概述对其他疾病的影响。为了估计水、环境卫生和个人卫生对腹泻的影响，我们选择了既有充分的全球暴露数据又有匹配的风险-风险关系的暴露水平。对2012年的全球接触数据进行了估计，并根据最新的系统分析进行了风险估计。我们分别按国家、年龄和性别估计了水、卫生设施和手部卫生不足的归因死亡和残疾调整生命年（DADs），并将其作为一组风险因素。不确定性估计数是根据接触估计数和相对风险的不确定性计算的。2012年，估计有502，000例腹泻死亡是由饮用水不足造成的，280，000例死亡是由卫生设施不足造成的。最有可能的估计是，手部卫生不足造成的疾病负担高达29.7万人死亡。据估计，共有84.2万例腹泻死亡是由这一组风险因素造成的，占疾病总负担的1.5%，占腹泻病的58%。在5岁以下儿童中，361 000例死亡可以避免，占该年龄组死亡人数的5.5%。这一估计数证实了改善中低收入环境中的水和环境卫生对预防肠道疾病负担的重要性。它还强调需要更好的数据，说明通过提供可靠的自来水、经过处理的社区污水和手部卫生可以实现的接触和风险降低。
To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene.
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影响因子：
168.9
作者：
Black, Robert E.;Victora, Cesar G.;Uauy, Ricardo
通讯作者：
Uauy, Ricardo
影响因子：
12.7
作者：
Dreibelbis, Robert;Freeman, Matthew C.;Rheingans, Richard
通讯作者：
Rheingans, Richard
影响因子：
11.4
作者：
Gunnarsdottir, Maria J.;Gardarsson, Sigurdur M.;Bartram, Jamie
通讯作者：
Bartram, Jamie
影响因子：
4.2
作者：
Freeman, M. C.;Clasen, T.;Rheingans, R.
通讯作者：
Rheingans, R.
DOI：
10.4269/ajtmh.2008.79.407
发表时间：
2008-09-01
影响因子：
3.3
作者：
Clasen, Thomas;McLaughlin, Catherine;Shah, Nimish
通讯作者：
Shah, Nimish