biostudies-literatureContreras JDNICHD NIH HHSNIEHS NIH HHSNational Institutes of HealthBill and Melinda Gates FoundationChan Zuckerberg InitiativeNIH HHS765-778https://www.ebi.ac.uk/biostudies/studies/S-EPMC11444030biostudies-literatureUnknown14(3)<h4>Background</h4>The WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea.<h4>Methods</h4>We conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention's effect on diarrhea through its effect on the mediator.<h4>Results</h4>The intervention improved all indicators comparedJournal of epidemiology and global healthImproved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh.PMC114440300PPGD759R01 HD078912P30 ES025128R01HD078912Hubbard AELuby SPContreras JDBenjamin-Chung JColford JMMertens AArnold BFIslam MUnicomb LPickering AJRahman MErcumen AfalseImproved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh.<h4>Background</h4>The WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea.<h4>Methods</h4>We conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention's effect on diarrhea through its effect on the mediator.<h4>Results</h4>The intervention improved all indicators compared2024-01-01T00:00:00Z2024 Sep2026-06-03T03:43:07.222Z2025-04-04T02:00:59.795ZS-EPMC114440303850718410.1007/s44197-024-00210-y