Journal article
Shared sanitation versus individual household latrines: a systematic review of health outcomes
PloS one, Vol.9(4), pp.e93300-e93300
2014
DOI: 10.1371/journal.pone.0093300
PMCID: PMC3990518
PMID: 24743336
Abstract
More than 761 million people rely on shared sanitation facilities. These have historically been excluded from international sanitation targets, regardless of the service level, due to concerns about acceptability, hygiene and access. In connection with a proposed change in such policy, we undertook this review to identify and summarize existing evidence that compares health outcomes associated with shared sanitation versus individual household latrines.
Shared sanitation included any type of facilities intended for the containment of human faeces and used by more than one household, but excluded public facilities. Health outcomes included diarrhoea, helminth infections, enteric fevers, other faecal-oral diseases, trachoma and adverse maternal or birth outcomes. Studies were included regardless of design, location, language or publication status. Studies were assessed for methodological quality using the STROBE guidelines. Twenty-two studies conducted in 21 countries met the inclusion criteria. Studies show a pattern of increased risk of adverse health outcomes associated with shared sanitation compared to individual household latrines. A meta-analysis of 12 studies reporting on diarrhoea found increased odds of disease associated with reliance on shared sanitation (odds ratio (OR) 1.44, 95% CI: 1.18-1.76).
Evidence to date does not support a change of existing policy of excluding shared sanitation from the definition of improved sanitation used in international monitoring and targets. However, such evidence is limited, does not adequately address likely confounding, and does not identify potentially important distinctions among types of shared facilities. As reliance on shared sanitation is increasing, further research is necessary to determine the circumstances, if any, under which shared sanitation can offer a safe, appropriate and acceptable alternative to individual household latrines.
Details
- Title: Subtitle
- Shared sanitation versus individual household latrines: a systematic review of health outcomes
- Creators
- Marieke Heijnen - Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United KingdomOliver Cumming - Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United KingdomRachel Peletz - Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United KingdomGabrielle Ka-Seen Chan - Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United KingdomJoe Brown - School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of AmericaKelly Baker - Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of AmericaThomas Clasen - Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.9(4), pp.e93300-e93300
- DOI
- 10.1371/journal.pone.0093300
- PMID
- 24743336
- PMCID
- PMC3990518
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- Public Library of Science; United States
- Language
- English
- Date published
- 2014
- Academic Unit
- Occupational and Environmental Health; Epidemiology
- Record Identifier
- 9983997362702771
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