Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma.
Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma.
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DOI：
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发表时间：
1991
影响因子：
11.1
通讯作者：
S. Esrey;J. Potash;L. Roberts;C. Shiff
中科院分区：
文献类型：
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作者：
S. Esrey;J. Potash;L. Roberts;C. Shiff
总共分析了 144 项研究，以检验改善供水和卫生设施对蛔虫病、腹泻、麦地那龙线虫病、钩虫感染、血吸虫病和沙眼的影响。选择这些疾病是因为它们广泛存在，并说明了改善水和卫生设施可以保护人们的多种机制。计算了所有研究的特定疾病中位减少水平，并分别计算了方法学上更严格的研究。对于后面的研究，供水和/或卫生设施引起的腹泻、沙眼和蛔虫病发病率的中位降低分别为 26%、27% 和 29%；血吸虫病和麦地那龙线虫病的中位减少率较高，分别为 77% 和 78%。除了一项报告称钩虫感染的发病率降低了 4% 之外，所有关于钩虫感染的研究都存在缺陷。对于钩虫感染、蛔虫病和血吸虫病，以虫卵计数衡量的疾病严重程度的降低幅度大于发病率或患病率的降低幅度。儿童死亡率下降了 55%，这表明水和卫生设施对儿童生存具有重大影响。个人和家庭卫生用水对于降低蛔虫病、腹泻、血吸虫病和沙眼的发病率非常重要。卫生设施降低了腹泻发病率和死亡率以及钩虫感染的严重程度。更好的水质降低了麦地那龙线虫病的发病率，但其在腹泻病控制中的作用不如环境卫生和个人卫生重要。
A total of 144 studies were analysed to examine the impact of improved water supply and sanitation facilities on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma. These diseases were selected because they are widespread and illustrate the variety of mechanisms through which improved water and sanitation can protect people. Disease-specific median reduction levels were calculated for all studies, and separately for the more methodologically rigorous ones. For the latter studies, the median reduction in morbidity for diarrhoea, trachoma, and ascariasis induced by water supplies and/or sanitation was 26%, 27%, and 29%, respectively; the median reduction for schistosomiasis and dracunculiasis was higher, at 77% and 78%, respectively. All studies of hookworm infection were flawed apart from one, which reported a 4% reduction in incidence. For hookworm infection, ascariasis, and schistosomiasis, the reduction in disease severity, as measured in egg counts, was greater than that in incidence or prevalence. Child mortality fell by 55%, which suggests that water and sanitation have a substantial impact on child survival. Water for personal and domestic hygiene was important in reducing the rates of ascariasis, diarrhoea, schistosomiasis, and trachoma. Sanitation facilities decreased diarrhoea morbidity and mortality and the severity of hookworm infection. Better water quality reduced the incidence of dracunculiasis, but its role in diarrhoeal disease control was less important than that of sanitation and hygiene.