Dataset Information

Effect of water, sanitation and hygiene interventions alone and combined with nutrition on child growth in low and middle income countries: a systematic review and meta-analysis.

ABSTRACT:

Objective

This study aimed to provide clarification on the benefits of water, sanitation and hygiene (WASH) alone separately and combined with nutrition in improving child growth outcomes.

Design

Systematic review and meta-analysis.

Methods

We conducted a systematic review using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed, MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science and Science Direct were searched in May 2018 and last updated in April 2019. We included studies that reported WASH interventions alone separately or combined with nutrition. Fixed and random-effects models were used to estimate pooled effect in mean difference (MD). Heterogeneity and publication bias statistics were performed.

Results

A total of 18 studies were included: 13 cluster randomised controlled trials (RCTs) and 5 non-randomised controlled trials (non-RCTs). Non-RCTs showed effect of WASH interventions alone on height-for-age z-score (HAZ) (MD=0.14; 95% CI 0.08 to 0.21) but RCTs did not. WASH alone of non-RCTs and RCTs that were delivered over 18-60 months indicated an effect on HAZ (MD=0.04; 95% CI 0.01 to 0.08). RCTs showed an effect for children <2 years (MD=0.07; 95% CI 0.01 to 0.13). Non-RCTs of WASH alone and those that included at least two components, improved HAZ (MD=0.15; 95% CI 0.07 to 0.23) but RCTs did not. WASH alone of non-RCTs and RCTs separately or together showed no effect on weight-for-age z-score (WAZ) and weight-for-height z-score (WHZ). Combined WASH with nutrition showed an effect on HAZ (MD=0.13; 95% CI 0.08 to 0.17) and on WAZ (MD=0.09; 95% CI 0.05 to 0.13) and was borderline on WHZ.

Conclusions

WASH interventions alone improved HAZ when delivered over 18-60 months and for children <2 years. Combined WASH with nutrition showed a strong effect on HAZ and WAZ and a borderline effect on WHZ. Integrated WASH with nutrition interventions may be effective inimproving child growth outcomes.

SUBMITTER: Bekele T

PROVIDER: S-EPMC7359184 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

Effect of water, sanitation and hygiene interventions alone and combined with nutrition on child growth in low and middle income countries: a systematic review and meta-analysis.

Bekele Tolesa T Rawstorne Patrick P Rahman Bayzidur B

BMJ open 20200712 7

<h4>Objective</h4>This study aimed to provide clarification on the benefits of water, sanitation and hygiene (WASH) alone separately and combined with nutrition in improving child growth outcomes.<h4>Design</h4>Systematic review and meta-analysis.<h4>Methods</h4>We conducted a systematic review using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed, MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science and Science Direct were searched in May 2018 and l ...[more]

PMID: 32660947

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Dataset Information

Effect of water, sanitation and hygiene interventions alone and combined with nutrition on child growth in low and middle income countries: a systematic review and meta-analysis.

Objective

Design

Methods

Results

Conclusions

Publications

Effect of water, sanitation and hygiene interventions alone and combined with nutrition on child growth in low and middle income countries: a systematic review and meta-analysis.

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