The joint effects of water and sanitation on diarrhoeal disease: a multicountry analysis of the Demographic and Health Surveys.
The joint effects of water and sanitation on diarrhoeal disease: a multicountry analysis of the Demographic and Health Surveys.
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DOI：
10.1111/tmi.12441
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Eisenberg JN
中科院分区：
文献类型：
--
作者：
Fuller JA;Westphal JA;Kenney B;Eisenberg JN
评估水和卫生基础设施的共同影响，无论它们是预防相同腹泻疾病的冗余服务、独立行动还是协同行动；并评估这些影响如何随国家和时间的推移而变化。我们使用了 1986 年至 2013 年间在 90 个国家进行的 217 项人口和健康调查的数据。我们使用修正的泊松回归来评估水和卫生基础设施对五岁以下儿童腹泻患病率的影响。水和卫生设施的影响因调查而异，并且对社会经济地位的调整使这些估计值趋向于零。当汇总所有 217 项调查时，卫生设施比供水基础设施的影响更大；然而，卫生设施的影响随着时间的推移而减弱。根据过去十年的调查数据，我们没有看到任何证据表明单独改善饮用水或卫生设施有好处，但我们估计两者相加可减少 6%（患病率 = 0.94，95% 置信限 0.91-0.98）。应将水和卫生干预措施结合起来，以最大程度地减少五岁以下儿童腹泻病例的数量。进一步的研究应该确定国家之间和不同时间之间的差异来源。这些国家调查可能在水和卫生设施的分类中存在重大测量误差，因此很难解释其他途径的作用。
To assess the joint effects of water and sanitation infrastructure, whether they are redundant services preventing the same cases of diarrheal disease, act independently, or act synergistically; and to assess how these effects vary by country and over time. We used data from 217 Demographic and Health Surveys conducted in 90 countries between 1986 and 2013. We used modified Poisson regression to assess the impact of water and sanitation infra-structure on the prevalence of diarrhea among children under five. The impact of water and sanitation varied across surveys, and adjusting for socioeconomic status drove these estimates towards the null. Sanitation had a greater effect than water infrastructure when all 217 surveys were pooled; however, the impact of sanitation diminished over time. Based on survey data from the past ten years, we saw no evidence for benefits in improving drinking water or sanitation alone, but we estimated a 6% reduction of both combined (prevalence ratio = 0.94, 95% confidence limit 0.91-0.98). Water and sanitation interventions should be combined to maximize the number of cases of diarrheal disease prevented in children under five. Further research should identify the sources of variability seen between countries and across time. These national surveys likely include substantial measurement error in the categorization of water and sanitation, making it difficult to interpret the roles of other pathways.
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影响因子：
168.9
作者：
Black, RE;Morris, SS;Bryce, J
通讯作者：
Bryce, J
影响因子：
12.7
作者：
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影响因子：
5
作者：
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通讯作者：
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7.7
作者：
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通讯作者：
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影响因子：
15.8
作者：
Bartram J;Cairncross S
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