The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986-2007
The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986-2007
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DOI：
10.1093/ije/dyr102
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发表时间：
2011-10-01
影响因子：
7.7
通讯作者：
Hill, Kenneth
中科院分区：
文献类型：
--
作者：
Fink, Guenther;Guenther, Isabel;Hill, Kenneth
为了调查儿童健康与获得水和卫生设施之间的关系，我们将所有可用的人口与健康调查（DHS）与完整的出生史和水和卫生设施信息合并。171项调查的合并数据集包括1986-2007年期间70个低收入和中等收入国家110万名5岁以下儿童的资料。我们使用逻辑模型来估计水和卫生设施的获得对婴儿和儿童死亡率、腹泻和发育迟缓的影响。（OR = 0.77，95%CI 0.68-0.86），儿童腹泻的风险较低（OR = 0.87，95%CI 0.85-0.90）和较低的轻度或重度发育迟缓风险（OR = 0.73，95%CI 0.71-0.75）。获得改善的水与腹泻风险降低有关（OR = 0.91，95%CI 0.88-0.94），轻度或重度发育迟缓的风险较低（OR = 0.92，95%CI 0.89-0.94），但未显示与非婴儿儿童死亡率有任何相关性结论虽然我们的点估计值表明保护作用比现有文献中报道的一些估计值略小，这篇文章中提出的结果有力地强调了缺乏水和卫生设施对年龄<在低收入和中等收入国家为5年。
Methods To investigate the associations between child health and access to water and sanitation, we merged all available Demographic and Health Surveys (DHS) with complete birth histories and water and sanitation information. The merged data set of 171 surveys includes information on 1.1 million children under the age of 5 years in 70 low- and middle-income countries over the period 1986-2007. We used logistic models to estimate the effect of water and sanitation access on infant and child mortality, diarrhoea and stunting.Results Access to improved sanitation was associated with lower mortality (OR = 0.77, 95% CI 0.68-0.86), a lower risk of child diarorhea (OR = 0.87, 95% CI 0.85-0.90) and a lower risk of mild or severe stunting (OR = 0.73, 95% CI 0.71-0.75). Access to improved water was associated with a lower risk of diarrhoea (OR = 0.91, 95% CI 0.88-0.94) and a lower risk of mild or severe stunting (OR = 0.92, 95% CI 0.89-0.94), but did not show any association with non-infant child mortality (OR = 0.97, 95% CI 0.88-1.04).Conclusions Although our point estimates indicate somewhat smaller protective effects than some of the estimates reported in the existing literature, the results presented in this article strongly underline the large health consequences of lacking access to water and sanitation for children aged < 5 years in low- and middle-income countries.