Cited by 296Parasites and Host InteractionsChild Nutrition and Water AccessMollusks and Parasites Studies

The relationship between water, sanitation and schistosomiasis: a systematic review and meta-analysis

Open access
Grimes, Jack E. T., Croll, David, Harrison, Wendy E., Utzinger, Jürg, Freeman, Matthew C., Templeton, Michael R.·2014·PLoS neglected tropical diseases

Abstract

BACKGROUND: Access to "safe" water and "adequate" sanitation are emphasized as important measures for schistosomiasis control. Indeed, the schistosomes' lifecycles suggest that their transmission may be reduced through safe water and adequate sanitation. However, the evidence has not previously been compiled in a systematic review. METHODOLOGY: We carried out a systematic review and meta-analysis of studies reporting schistosome infection rates in people who do or do not have access to safe water and adequate sanitation. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 31 December 2013, without restrictions on year of publication or language. Studies' titles and abstracts were screened by two independent assessors. Papers deemed of interest were read in full and appropriate studies included in the meta-analysis. Publication bias was assessed through the visual inspection of funnel plots and through Egger's test. Heterogeneity of datasets within the meta-analysis was quantified using Higgins' I2. PRINCIPAL FINDINGS: Safe water supplies were associated with significantly lower odds of schistosomiasis (odds ratio (OR) = 0.53, 95% confidence interval (CI): 0.47-0.61). Adequate sanitation was associated with lower odds of Schistosoma mansoni, (OR = 0.59, 95% CI: 0.47-0.73) and Schistosoma haematobium (OR = 0.69, 95% CI: 0.57-0.84). Included studies were mainly cross-sectional and quality was largely poor. CONCLUSIONS/SIGNIFICANCE: Our systematic review and meta-analysis suggests that increasing access to safe water and adequate sanitation are important measures to reduce the odds of schistosome infection. However, most of the studies were observational and quality was poor. Hence, there is a pressing need for adequately powered cluster randomized trials comparing schistosome infection risk with access to safe water and adequate sanitation, more studies which rigorously define water and sanitation, and new research on the relationships between water, sanitation, hygiene, human behavior, and schistosome transmission.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pntd.0003296

Cites

110 of 110 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [72]de Lima e Costa MFF, Rocha RS, Magalhaes MH, Katz N (1994) [A hierarchical model for analysis of socio-economic variables and water contact patterns associated with the hepatosplenic form of schistosomiasis]. Cad Saúde Pública 10 Suppl 2: 241– 253 (in Portuguese) 15042214

Cited by

Sorted by citations

Authors
Grimes, J. E. T., Croll, D., Harrison, W. E., Utzinger, J., Freeman, M. C., & Templeton, M. R.
Affiliations
  • Imperial College London (GB)
  • Swiss Tropical and Public Health Institute (CH)
  • Emory University (US)
Corresponding author
Grimes, Jack E. T.
Venue
PLoS neglected tropical diseases
Published
2014-12-04
Volume
8
Issue
12
Pages
e3296
ISSN
  • 1935-2727 (ISSN-L)
  • 1935-2735
OpenAlex
W2112225871
Cited by
296
References
110
Citations by year
2026: 13 · 2025: 28 · 2024: 19 · 2023: 26 · 2022: 32 · 2021: 21 · 2020: 31 · 2019: 29 · 2018: 23 · 2017: 25 · 2016: 26 · 2015: 23
FWCI
3.02
Type
journal article
Language
en
Open access
Locations
  • PLoS neglected tropical diseases (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • edoc (University of Basel) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Spiral (Imperial College London) (submittedVersion, other-oa)
Funders
  • London School of Hygiene and Tropical Medicine
  • Wellcome Trust
  • Imperial College London
  • Department for International Development
Topics
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Life Sciences › Agricultural and Biological Sciences › Insect Science › Mollusks and Parasites Studies
Keywords
schistosomiasis, safe water supply, sanitation, Schistosoma mansoni, Schistosoma haematobium, water, sanitation and hygiene, neglected tropical diseases
MeSH terms
Cross-Sectional Studies, Humans, Sanitation, Schistosomiasis, Water Supply, Water Quality

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review