Sharma Waddington Hugh, Cairncross Sandy
London School of Hygiene and Tropical Medicine London International Development Centre London UK.
London School of Hygiene and Tropical Medicine London UK.
Campbell Syst Rev. 2021 Jan 19;17(1):e1135. doi: 10.1002/cl2.1135. eCollection 2021 Mar.
Respiratory tract infections and diarrhoea are the two biggest killers of children in low income contexts. They are closely related to access to, and use of improved water, sanitation and hygiene (WASH). However, there is no high quality systematic review that quantifies the effect of WASH improvements on childhood mortality. Existing systematic reviews of WASH improvements measure effects on morbidity, under the (often implicit) assumption that morbidity is closely correlated with mortality. This is at least partly because the impact evaluations on which they are based are only designed to detect changes in morbidity with statistical precision, whereas mortality is a relatively rare outcome. The proposed review will address this evidence synthesis gap, using the greater statistical power of meta-analysis to pool findings across studies.
呼吸道感染和腹泻是低收入环境中儿童的两大杀手。它们与获得和使用改良的水、环境卫生和个人卫生(WASH)密切相关。然而,尚无高质量的系统评价来量化WASH改善对儿童死亡率的影响。现有的关于WASH改善的系统评价衡量的是对发病率的影响,其依据的是(通常隐含的)发病率与死亡率密切相关这一假设。这至少部分是因为它们所基于的影响评估仅旨在以统计精度检测发病率的变化,而死亡率是一个相对罕见的结果。拟议的评价将利用荟萃分析更强的统计效力汇总各项研究的结果,以填补这一证据综合方面的空白。