Burden of disease from inadequate water, sanitation and hygiene in low‐ and middle‐income settings: a retrospective analysis of data from 145 countries

Abstract

ObjectiveTo estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases.MethodsFor estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks.ResultsIn 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group.ConclusionsThis estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene.

Use, microbiological effectiveness and health impact of a household water filter intervention in rural Rwanda—A matched cohort study

“…Unsafe drinking water and household air pollution are two significant environmental health risks and contribute to diarrhoea and pneumonia, two major causes of death for children under 5 years of age (GBD 2015Risk Factors Collaborators, 2016Liu et al, 2014;Prüss-Ustün et al, 2014). In 2011, an estimated 700,000 deaths among children under 5 were due to diarrhoea (Fischer Walker et al, 2013b).…”

Factors Determining Water Treatment Behavior for the Prevention of Cholera in Chad

“…According to data from 145 low-and middle-income settings, the highest risk for diarrheal diseases within the cluster of risk factors results from inadequate drinking water. 3 Evidence on the positive effect of point-of-use treatment on water quality, and significant reductions in diarrheal diseases among its users, exists. [4][5][6][7][8][9][10][11] The usage of chlorine products has been described as one effective and easy-to-use means of water disinfection.…”

Yaşlılarda sağlıklı beslenme – sağlıklı su tüketimi

“…Yiyecekler, çay ve kahve gibi içeceklerle alınacak miktarın dışında tüketilmesi gereken bu su, tercihen oda sıcaklığında olmalıdır. İçilen suyun pH'ının 7.0-7.5 aralığında olması, sertliğinin ise 5-10Fr arasında bulunması önerilmektedir (6).…”

“…Çok yumuşak içimli kalsiyum içeriği zayıf suların içiminin daha kolay olmasına karşılık, 5-10Fr sertlikteki yumuşak suların tercih edilmesinde fayda bulunmaktadır. İçeriğinde bulunan kalsiyum, magnezyum, potasyum açısından zengin suların alkali pH'a sahip olduğu ve ideal içme suyu pH'nın 7.5-8 aralığında hafif alkali olması önerilmektedir (1,6).…”