Narrative Review of Primary Preventive Interventions against Water-Borne Diseases: Scientific Evidence of Health-EDRM in Contexts with Inadequate Safe Drinking Water

Abstract

Waterborne diseases account for 1.5 million deaths a year globally, particularly affecting children in low-income households in subtropical areas. It is one of the most enduring and economically devastating biological hazards in our society today. The World Health Organization Health Emergency and Disaster Risk Management (health-EDRM) Framework highlights the importance of primary prevention against biological hazards across all levels of society. The framework encourages multi-sectoral coordination and lessons sharing for community risk resilience. A narrative review, conducted in March 2021, identified 88 English-language articles published between January 2000 and March 2021 examining water, sanitation, and hygiene primary prevention interventions against waterborne diseases in resource-poor settings. The literature identified eight main interventions implemented at personal, household and community levels. The strength of evidence, the enabling factors, barriers, co-benefits, and alternative measures were reviewed for each intervention. There is an array of evidence available across each intervention, with strong evidence supporting the effectiveness of water treatment and safe household water storage. Studies show that at personal and household levels, interventions are effective when applied together. Furthermore, water and waste management will have a compounding impact on vector-borne diseases. Mitigation against waterborne diseases require coordinated, multi-sectoral governance, such as building sanitation infrastructure and streamlined waste management. The review showed research gaps relating to evidence-based alternative interventions for resource-poor settings and showed discrepancies in definitions of various interventions amongst research institutions, creating challenges in the direct comparison of results across studies.

Water-related diseases following flooding in South Asian countries – a healthcare crisis

“…According to WHO, infectious WBD are one of the leading causes of morbidity and mortality in humans worldwide accounting for 1.5 million deaths annually. 6 Water-borne outbreaks are among the most well-known, immediate effects of flood catastrophes promoted by the failure of sewage disposal and purification systems. However, additional impacts of flooding, such as displacement of large numbers of people into over-crowded shelters and subsequent fecal-oral dissemination of gastrointestinal pathogens, may contribute to the acute aftermath of the flood.…”

Water sanitation problem in Pakistan: A review on disease prevalence, strategies for treatment and prevention

“…In order to maintain baseline water quality, routine check-ups of the chlorine levels in house hold waters should be performed [ 37 ]. Chlorine tablets are administered as water disinfectants and are often efficiently used to kill pathogens present in the water.…”

Exploring drivers of unsafe disposal of child stool in India using hierarchical regression model

“…Similarly, unsafe disposal of child stool leads to a 35% elevation in helminth infections in Bangladesh [ 5 ]. Unsafe disposal of child stool also contributes to the proliferation of waterborne diseases [ 6 ]. Beyond its immediate adverse effects, the unsafe disposal of stool from young children amplifies the potential for long-term undernutrition, particularly stunting [ 7 ].…”

“…In parallel, inadequate management of child stool heightens the likelihood of enduring cognitive impairment among this demographic group in their later lives [8]. Therefore, proper stool management is crucial to minimizing short-and long-term health risks among children [6][7][8][9].…”