Prüss-Ustün, A, Wolf, J, Bartram, J orcid.org/0000-0002-6542-6315 et al. (7 more authors) (2019) Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: An updated analysis with a focus on low- and middle-income countries. International Journal of Hygiene and Environmental Health, 222 (5). pp. 765-777. ISSN 1438-4639
Abstract
Background
To develop updated estimates in response to new exposure and exposure-response data of the burden of diarrhoea, respiratory infections, malnutrition, schistosomiasis, malaria, soil-transmitted helminth infections and trachoma from exposure to inadequate drinking-water, sanitation and hygiene behaviours (WASH) with a focus on low- and middle-income countries.
Methods
For each of the analysed diseases, exposure levels with both sufficient global exposure data for 2016 and a matching exposure-response relationship were combined into population-attributable fractions. Attributable deaths and disability-adjusted life years (DALYs) were estimated for each disease and, for most of the diseases, by country, age and sex group separately for inadequate water, sanitation and hygiene behaviours and for the cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks.
Findings
An estimated 829,000 WASH-attributable deaths and 49.8 million DALYs occurred from diarrhoeal diseases in 2016, equivalent to 60% of all diarrhoeal deaths. In children under 5 years, 297,000 WASH-attributable diarrhoea deaths occurred, representing 5.3% of all deaths in this age group. If the global disease burden from different diseases and several counterfactual exposure distributions was combined it would amount to 1.6 million deaths, representing 2.8% of all deaths, and 104.6 million DALYs in 2016.
Conclusions
Despite recent declines in attributable mortality, inadequate WASH remains an important determinant of global disease burden, especially among young children. These estimates contribute to global monitoring such as for the Sustainable Development Goal indicator on mortality from inadequate WASH.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 World Health Organization; licensee Elsevier. This is an open access article under the CC BY 3.0 license (http://creativecommons.org/licenses/BY 3.0/IGO/). |
Keywords: | Burden of disease; Comparative risk assessment; Drinking water; Water; Sanitation; Hygiene; Diarrhoea; Hand washing |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Civil Engineering (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 24 Apr 2020 09:17 |
Last Modified: | 24 Apr 2020 09:17 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.ijheh.2019.05.004 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:159013 |