| Titre : | Development and use of the Lives Saved Tool (LiST) : A model to estimate the impact of scaling up proven interventions on maternal, neonatal and child mortality. Water, sanitation and hygiene for the prevention of diarrhoea. (2010) |
| Auteurs : | Sandy Cairncross ; Sophie BOISSON ; Kristof BOSTOEN ; Val CURTIS ; FUNG (Isaac-Ch) : USA. Department of Epidemiology and Biostatistics. College of Public Health. University of Georgia. Athens. GA. ; Caroline HUNT ; Wolf-Peter SCHMIDT ; VICTORA (Cesar-G) : BRA. Department of Programa de Pos-Graduaçao em Epidemiologia. Universidade Federal de Pelotas. Pelotas. ; London School of Hygiene & Tropical Medicine. Department of Infectious & Tropical Diseases. London. GBR |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 39, 2010) |
| Pagination : | I193-I205 |
| Langues: | Anglais |
| Mots-clés : | Diarrhée ; Qualité eau ; Hygiène ; Prévention santé ; Eau ; Equipement sanitaire ; Mortalité ; Epidémiologie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS BR0xI8sm. Diffusion soumise à autorisation]. Background Ever since John Snow's intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality. Methods We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate. Results The striking effect of handwashing with soap is consistent across various study designs and pathogens, though it depends on access to water. The effect of water treatment appears similarly large, but is not found in few blinded studies, suggesting that it may be partly due to the placebo effect. There is very little rigorous evidence for the health benefit of sanitation ; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese. Conclusion We propose diarrhoea risk reductions of 48,17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the LiST model. Most of the evidence is of poor quality. More trials are needed, but the evidence is nonetheless strong enough to support the provision of water supply, sanitation and hygiene for all. |
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