Assessing the impact of sanitation on indicators of fecal exposure along principal transmission pathways: A systematic review.
Assessing the impact of sanitation on indicators of fecal exposure along principal transmission pathways: A systematic review.
复制标题
评估卫生设施对主要传播途径粪便暴露指标的影响：系统评价。
DOI：
10.1016/j.ijheh.2016.09.021
复制
发表时间：
2016
影响因子：
6
通讯作者：
T. Clasen
中科院分区：
文献类型：
--
作者：
G. Sclar;Gauthami Penakalapati;Heather K. Amato;J. Garn;Kelly T. Alexander;M. Freeman;S. Boisson;K. Medlicott;T. Clasen
卫生条件差造成的肠道和其他病原体的粪-口传播是发病和死亡的主要原因，特别是在低收入或中等收入环境中。很少有研究调查卫生设施对传播指标的影响，而传播指标是实现健康收益的先决条件。这篇评论试图总结文献data.MethodsWe搜索领先的数据库，以确定研究，解决卫生对各种传播途径的影响，包括粪便病原体或指示细菌在饮用水，手污染，哨兵玩具，食品，家庭和厕所表面和土壤，以及苍蝇和观察人类粪便。这还包括根据与卫生设施的距离评估粪便污染对供水的影响的研究。我们确定了29项研究，符合审查的合格criteria.Results和conclusionOverall，研究发现，这些传播途径的卫生干预措施几乎没有影响。没有证据表明对水质（水源或家庭）、手部或哨点玩具污染、食品污染或表面或土壤污染有影响。有一些证据表明，卫生与苍蝇减少有关，对粪便观察结果的影响较小（风险差异-0.03，95%CI-0.06至0.01）。研究表明，供水系统与厕所的距离与这种供水系统的粪便污染程度成反比。今后对卫生干预措施的评价应包括对传播途径沿着影响的评估，以便更好地了解在何种情况下干预措施可有效预防疾病。
ObjectiveFecal-oral transmission of enteric and other pathogens due to poor sanitation is a major cause of morbidity and mortality, especially in low- or middle-income settings. Few studies have investigated the impact of sanitation on indicators of transmission, a prerequisite to achieving health gains. This review attempts to summarize the literature to date.MethodsWe searched leading databases to identify studies that address the effect of sanitation on various transmission pathways including fecal pathogens or indicator bacteria in drinking water, hand contamination, sentinel toys, food, household and latrine surfaces and soil, as well as flies and observations of human feces. This also included studies that assessed the impact of fecal contamination of water supplies based on distance from sanitation facilities. We identified 29 studies that met the review’s eligibility criteria.Results and conclusionOverall, the studies found little to no effect from sanitation interventions on these transmission pathways. There was no evidence of effects on water quality (source or household), hand or sentinel toy contamination, food contamination, or contamination of surfaces or soil. There is some evidence that sanitation was associated with reductions in flies and a small effect on observations of feces (Risk Difference −0.03, 95%CI −0.06 to 0.01). Studies show an inverse relationship between the distance of a water supply from a latrine and level of fecal contamination of such water supply. Future evaluations of sanitation interventions should include assessments of effects along transmission pathways in order to better understand the circumstances under which interventions may be effective at preventing disease.