Yusuke Matsuyama, Aya Isumi, Satomi Doi, Takeo Fujiwara
69th Annual ORCA Congress 2022
Caries research
preventive chemotherapy represents powerful shortterm control strategy soiltransmitted helminthiasis since humans often reinfected rapidly longterm solutions require improvements water sanitation hygiene wash purpose study quantitatively summarize relationship wash access practices soiltransmitted helminth sth infectionwe conducted systematic review metaanalysis examine associations improved wash infection sth ascaris lumbricoides trichuris trichiura hookworm ancylostoma duodenale necator americanus strongyloides stercoralis pubmed embase web science lilacs searched inception october 28 2013 language restrictions studies eligible inclusion provided estimate effect wash access practices sth infection assessed quality published studies grades recommendation assessment development evaluation grade approach total 94 studies met eligibility criteria five randomized controlled trials whilst others crosssectional studies used randomeffects metaanalyses analyzed adjusted estimates help account heterogeneity potential confounding respectively use treated water associated lower odds sth infection odds ratio 046 95 ci 036060 piped water access associated lower odds lumbricoides 040 95 ci 039041 trichiura infection 057 95 ci 045072 sth infection 093 95 ci 028311 access sanitation associated decreased likelihood infection sth 066 95 ci 057076 trichiura 061 95 ci 050074 lumbricoides 062 95 ci 044088 hookworm infection 080 95 ci 061106 wearing shoes associated reduced odds hookworm infection 029 95 ci 018047 infection sth 030 95 ci 011083 handwashing eating 038 95 ci 026055 defecating 045 95 ci 035058 associated lower odds lumbricoides infection soap use availability significantly associated lower infection sth 053 95 ci 029098 handwashing defecation 047 95 ci 024090 observational evidence constituted majority included literature limits attempt make causal inferences due underlying heterogeneity across observational studies metaanalysis results reflect average many potentially distinct effects average one specific exposureoutcome relationshipwash access practices generally associated reduced odds sth infection pooled estimates metaanalyses except two indicated least 33 reduction odds infection associated individual wash practices access although wash interventions sth focused sanitation access water hygiene also appear significantly reduce odds infection overall quality evidence low due preponderance observational studies though recent randomized controlled trials underscored benefit handwashing interventions limited use joint monitoring programs standardized water sanitation definitions literature restricted efforts generalize across studies research warranted determine magnitude benefit wash interventions sth control results call multisectoral integrated intervention packages tailored socialecological contexts