IV.2 Caracterización y análisis del sistema ambiental .1 Aspectos abióticos
IV.2.4 Medio socioeconómico Demografía
Comparison 1. CRCTs: Hygiene education vs control
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
1.1 diarrhoea 2 Risk Ratio(IV, Random, 95% CI) 0.83 [0.73, 0.94]
Comparison 2. CRCTs: Sanitation intervention vs control
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
2.1 diarrhoea 4 Risk Ratio(IV, Random, 95% CI) 0.93 [0.83, 1.04]
2.2 any helminth 2 Risk Ratio(IV, Random, 95% CI) 1.03 [0.78, 1.37]
2.3 Ascaris lumbricoides present 2 Risk Ratio(IV, Random, 95% CI) 1.01 [0.74, 1.39]
2.4 Dysentery 2 Risk Ratio(IV, Random, 95% CI) 0.63 [0.31, 1.30]
2.5 Anthropometry: HAZ 4 Mean Difference(IV, Random, 95% CI) 0.05 [-0.07, 0.17]
2.6 Anthropometry: WAZ 4 Mean Difference(IV, Random, 95% CI) 0.02 [-0.06, 0.09]
Comparison 3. CBA: WASH interventions vs control
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
3.1 diarrhoea 2 Risk Ratio(IV, Random, 95% CI) 0.77 [0.71, 0.84]
Comparison 4. controlled cohort studies: SHEWA-B vs control
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
4.1 diarrhoea 2 Risk Ratio(IV, Random, 95% CI) 0.91 [0.64, 1.28]
4.2 safe vs unsafe child faeces disposal 2 Risk Ratio(IV, Random, 95% CI) 1.10 [0.72, 1.67]
Comparison 5. Case-control studies: disposal of child faeces in latrine vs elsewhere
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
5.1 Diarrhoea (including severe and cholera): 22 Odds Ratio(IV, Random, 95% CI) 0.77 [0.69, 0.85]
subgrouped by age group
5.1.1 All ages 22 Odds Ratio(IV, Random, 95% CI) 0.76 [0.66, 0.88]
5.1.2 ≤5 years 19 Odds Ratio(IV, Random, 95% CI) 0.77 [0.66, 0.89]
5.2 Diarrhoea (including severe and cholera):
subgrouped by country income level 22 Odds Ratio(IV, Random, 95% CI) 0.76 [0.66, 0.88]
5.2.1 low 8 Odds Ratio(IV, Random, 95% CI) 0.68 [0.43, 1.09]
5.2.2 lower middle 10 Odds Ratio(IV, Random, 95% CI) 0.82 [0.70, 0.96]
5.2.3 upper middle 3 Odds Ratio(IV, Random, 95% CI) 0.75 [0.60, 0.94]
5.2.4 high 1 Odds Ratio(IV, Random, 95% CI) 0.68 [0.48, 0.97]
5.3 Diarrhoea (including severe and cholera):
subgrouped by type of diarrhoea 22 Odds Ratio(IV, Random, 95% CI) 0.76 [0.66, 0.88]
5.3.1 Persistent diarrhoea 1 Odds Ratio(IV, Random, 95% CI) 0.53 [0.17, 1.68]
5.3.2 Moderate to severe diarrhoea 7 Odds Ratio(IV, Random, 95% CI) 0.96 [0.83, 1.11]
5.3.3 Acute (possibly) bloody diarrhoea 4 Odds Ratio(IV, Random, 95% CI) 0.67 [0.56, 0.81]
5.3.4 Acute watery diarrhoea 5 Odds Ratio(IV, Random, 95% CI) 0.76 [0.48, 1.22]
5.3.5 No case definition 5 Odds Ratio(IV, Random, 95% CI) 0.54 [0.39, 0.75]
5.4 Diarrhoea (including severe and cholera):
subgrouped by study quality 22 Odds Ratio(IV, Random, 95% CI) 0.76 [0.66, 0.88]
5.4.1 4 stars 7 Odds Ratio(IV, Random, 95% CI) 0.96 [0.83, 1.11]
5.4.2 5 stars 7 Odds Ratio(IV, Random, 95% CI) 0.65 [0.52, 0.82]
5.4.3 6 stars 3 Odds Ratio(IV, Random, 95% CI) 0.71 [0.38, 1.33]
5.4.4 7+ stars 5 Odds Ratio(IV, Random, 95% CI) 0.66 [0.51, 0.84]
5.5 Diarrhoea (including severe and cholera):
subgrouped by setting 22 Odds Ratio(IV, Random, 95% CI) 0.76 [0.66, 0.88]
5.5.1 Rural 9 Odds Ratio(IV, Random, 95% CI) 0.72 [0.55, 0.94]
5.5.2 Urban 10 Odds Ratio(IV, Random, 95% CI) 0.74 [0.61, 0.90]
5.5.3 Peri-urban/urban and rural 3 Odds Ratio(IV, Random, 95% CI) 0.98 [0.70, 1.38]
5.6 Diarrhoea (including severe and cholera):
subgrouped by method of data collection 22 Odds Ratio(IV, Random, 95% CI) 0.76 [0.66, 0.88]
5.6.1 questionnaire 18 Odds Ratio(IV, Random, 95% CI) 0.80 [0.69, 0.93]
5.6.2 observation 2 Odds Ratio(IV, Random, 95% CI) 0.48 [0.29, 0.79]
5.6.3 unclear 2 Odds Ratio(IV, Random, 95% CI) 0.67 [0.48, 0.94]
Comparison 6. Case-control studies: defecation of children in latrine vs elsewhere
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
6.1 Diarrhoea: case-control studies:
subgrouped by age group 7 Odds Ratio(IV, Random, 95% CI) 0.56 [0.39, 0.80]
6.1.1 All ages 7 Odds Ratio(IV, Random, 95% CI) 0.54 [0.33, 0.90]
6.1.2 ≤5 years 5 Odds Ratio(IV, Random, 95% CI) 0.54 [0.28, 1.07]
6.2 Diarrhoea: case-control studies:
subgrouped by country income level 7 Odds Ratio(IV, Random, 95% CI) 0.54 [0.33, 0.90]
6.2.1 low 3 Odds Ratio(IV, Random, 95% CI) 0.61 [0.23, 1.60]
6.2.2 lower middle 2 Odds Ratio(IV, Random, 95% CI) 0.23 [0.11, 0.48]
6.2.3 upper middle 2 Odds Ratio(IV, Random, 95% CI) 0.78 [0.53, 1.14]
6.3 Diarrhoea: case-control studies:
subgrouped by type of diarrhoea 7 Odds Ratio(IV, Random, 95% CI) 0.54 [0.33, 0.90]
6.3.1 Other 1 Odds Ratio(IV, Random, 95% CI) 0.14 [0.03, 0.52]
6.3.2 Persistent diarrhoea 1 Odds Ratio(IV, Random, 95% CI) 0.27 [0.12, 0.60]
6.3.3 Acute (possibly) bloody diarrhoea 2 Odds Ratio(IV, Random, 95% CI) 0.85 [0.65, 1.12]
6.3.4 Acute watery diarrhoea 3 Odds Ratio(IV, Random, 95% CI) 0.58 [0.20, 1.65]
6.4 Diarrhoea: case-control studies:
subgrouped by study quality 7 Odds Ratio(IV, Random, 95% CI) 0.54 [0.33, 0.90]
6.4.1 4 stars 2 Odds Ratio(IV, Random, 95% CI) 0.13 [0.05, 0.37]
6.4.2 5 stars 1 Odds Ratio(IV, Random, 95% CI) 0.27 [0.12, 0.60]
6.4.3 6 stars 3 Odds Ratio(IV, Random, 95% CI) 0.82 [0.57, 1.17]
6.4.4 7 stars 1 Odds Ratio(IV, Random, 95% CI) 0.91 [0.64, 1.29]
6.5 Diarrhoea: case-control studies:
subgrouped by setting 7 Odds Ratio(IV, Random, 95% CI) 0.54 [0.33, 0.90]
6.5.1 rural 1 Odds Ratio(IV, Random, 95% CI) 0.75 [0.29, 1.93]
6.5.2 semi-urban 1 Odds Ratio(IV, Random, 95% CI) 0.79 [0.52, 1.19]
6.5.3 Urban 5 Odds Ratio(IV, Random, 95% CI) 0.40 [0.17, 0.94]
6.6 Diarrhoea: case-control studies:
subgrouped by by method of data collection 7 Odds Ratio(IV, Random, 95% CI) 0.54 [0.33, 0.90]
6.6.1 questionnaire 5 Odds Ratio(IV, Random, 95% CI) 0.75 [0.50, 1.13]
6.6.2 observation 1 Odds Ratio(IV, Random, 95% CI) 0.13 [0.02, 0.66]
6.6.3 unclear 1 Odds Ratio(IV, Random, 95% CI) 0.27 [0.12, 0.60]
Comparison 7. controlled cross-sectional: HEP model households vs non-model
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
7.1 diarrhoea 2 Odds Ratio(IV, Random, 95% CI) 0.26 [0.16, 0.42]
Comparison 8. Trials: behaviour change after intervention
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
8.1 No open defecation by children <5 4 Risk Ratio(IV, Random, 95% CI) 1.56 [0.76, 3.20]
8.2 Latrine use by children 2 Risk Ratio(IV, Random, 95% CI) 1.69 [0.26, 11.04]
8.3 Potty use by children 3 Risk Ratio(IV, Random, 95% CI) 1.85 [0.81, 4.23]
8.4 Safe disposal of child faeces 4 Risk Ratio(IV, Random, 95% CI) 1.19 [1.01, 1.40]
8.5 faeces not observed in yard/ HH 2 Risk Ratio(IV, Random, 95% CI) 1.09 [0.61, 1.94]
Comparison 9. controlled cross-sectional studies: behaviour change
Outcome or Subgroup Studies Participants Statistical Method Effect Estimate
9.1 safe vs unsafe child faeces disposal 3 Risk Ratio(IV, Random, 95% CI) 1.57 [1.12, 2.20]
9.1.1 BRAC 1 Risk Ratio(IV, Random, 95% CI) 4.25 [1.91, 9.46]
9.1.2 HEP 2 Risk Ratio(IV, Random, 95% CI) 1.36 [0.98, 1.89]
Analysis 1.1. Comparison 1. CRCTs: Hygiene education vs control, Outcome 1 diarrhoea.
Analysis 2.1. Comparison 2. CRCTs: Sanitation intervention vs control, Outcome 1 diarrhoea
Analysis 2.2. Comparison 2. CRCTs: Sanitation intervention vs control, Outcome 2 any helminth.
Analysis 2.3. Comparison 2. CRCTs: Sanitation intervention vs control, Outcome 3 Ascaris lumbricoides present
Analysis 2.4. Comparison 2. CRCTs: Sanitation intervention vs control, Outcome 4 Dysentery
Analysis 2.5. Comparison 2. CRCTs: Sanitation intervention vs control, Outcome 5 Anthropometry: HAZ
Analysis 2.6. Comparison 2. CRCTs: Sanitation intervention vs control, Outcome 6 Anthropometry: WAZ
Analysis 3.1. Comparison 3. CBA: WASH interventions vs control, Outcome 1 diarrhoea
Analysis 4.1. Comparison 4. Controlled cohort studies: SHEWA-B vs control, Outcome 1 diarrhoea
Analysis 4.2. Comparison 4. Controlled cohort studies: SHEWA-B vs control, Outcome 2 safe vs unsafe child faeces disposal
Analysis 5.1. Comparison 5. Case-control studies: disposal of child faeces in latrine vs elsewhere, Outcome 1 Diarrhoea (including severe and cholera): subgrouped by age group
Analysis 5.2. Comparison 5. Case-control studies: disposal of child faeces in latrine vs elsewhere, Outcome 2 Diarrhoea (including severe and cholera): subgrouped by income level
Analysis 5.3. Comparison 5. Case-control studies: disposal of child faeces in latrine vs elsewhere, Outcome3 Diarrhoea (including severe and cholera): subgrouped by type of diarrhoea
Analysis 5.4. Comparison 5. Case-control studies: disposal of child faeces in latrine vs elsewhere, Outcome 4 Diarrhoea (including severe and cholera): subgrouped by study quality.
Analysis 5.5. Comparison 5. Case-control studies: disposal of child faeces in latrine vs elsewhere, Outcome 5 Diarrhoea (including severe and cholera): subgrouped by setting.
Analysis 5.6. Comparison 5. Case-control studies: disposal of child faeces in latrine vs elsewhere, Outcome 6 Diarrhoea (including severe and cholera): subgrouped by method of data collection
Analysis 6.1. Comparison 6. Case-control studies: defecation of children in latrine vs elsewhere, Outcome 1 Diarrhoea: subgrouped by age group
Analysis 6.2. Comparison 6. Case-control studies: defecation of children in latrine vs elsewhere, Outcome 2 Diarrhoea: subgrouped by country income level.
Analysis 6.3. Comparison 6. Case-control studies: defecation of children in latrine vs elsewhere, Outcome 1 Diarrhoea: subgrouped by type of diarrhoea
Analysis 6.4. Comparison 6. Case-control studies: defecation of children in latrine vs elsewhere, Outcome 4 Diarrhoea: subgrouped by study quality
Analysis 6.5. Comparison 6. Case-control studies: defecation of children in latrine vs elsewhere, Outcome 5 Diarrhoea: subgrouped by setting
Analysis 6.6. Comparison 6. Case-control studies: defecation of children in latrine vs elsewhere, Outcome 6 Diarrhoea: subgrouped by method of data collection
Analysis 7.1. Comparison 7. controlled cross-sectional: HEP model households vs non-model, Outcome 1 Diarrhoea
Analysis 8.1. Comparison 8. Trials: behaviour change after intervention, Outcome 1 No open defecation by children <5
Analysis 8.2. Comparison 8. Trials: behaviour change after intervention, Outcome 2 Latrine use by children
Analysis 8.3. Comparison 8. Trials: behaviour change after intervention, Outcome 3 Potty use by children
Analysis 8.4. Comparison 8. Trials: behaviour change after intervention, Outcome 4 Safe disposal of child faeces
Analysis 8.5. Comparison 8. Trials: behaviour change after intervention, Outcome 5 Faeces not observed in yard/ HH
Analysis 9.1. Comparison 9. Controlled cross-sectional studies: behaviour change, Outcome 1 safe vs unsafe child faeces disposal