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Jennyfer Wolf, Richard Bart Johnston, Argaw B. Ambelu, Benjamin F. Arnold, Robert Bain, Michael D Brauer, Joe M. Brown, Bethany A. Caruso, Thomas Clasen, John M. Colford and 11 more
BACKGROUND: Assessments of disease burden are important to inform national, regional, and global strategies and to guide investment. We aimed to estimate the drinking water, sanitation, and hygiene (WASH)-attributable burden of disease for diarrhoea, acute respiratory infections, undernutrition, and soil-transmitted helminthiasis, using the WASH service levels used to monitor the UN Sustainable Development Goals (SDGs) as counterfactual minimum risk-exposure levels. METHODS: We assessed the WASH-attributable disease burden of the four health outcomes overall and disaggregated by region, age, and sex for the year 2019. We calculated WASH-attributable fractions of diarrhoea and acute respiratory infections by country using modelled WASH exposures and exposure-response relationships from two updated meta-analyses. We used the WHO and UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene public database to estimate population exposure to different WASH service levels. WASH-attributable undernutrition was estimated by combining the population attributable fractions (PAF) of diarrhoea caused by unsafe WASH and the PAF of undernutrition caused by diarrhoea. Soil-transmitted helminthiasis was fully attributed to unsafe WASH. FINDINGS: We estimate that 1·4 (95% CI 1·3-1·5) million deaths and 74 (68-80) million disability-adjusted life-years (DALYs) could have been prevented by safe WASH in 2019 across the four designated outcomes, representing 2·5% of global deaths and 2·9% of global DALYs from all causes. The proportion of diarrhoea that is attributable to unsafe WASH is 0·69 (0·65-0·72), 0·14 (0·13-0·17) for acute respiratory infections, and 0·10 (0·09-0·10) for undernutrition, and we assume that the entire disease burden from soil-transmitted helminthiasis was attributable to unsafe WASH. INTERPRETATION: WASH-attributable burden of disease estimates based on the levels of service established under the SDG framework show that progress towards the internationally agreed goal of safely managed WASH services for all would yield major public-health returns. FUNDING: WHO and Foreign, Commonwealth & Development Office.
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Wolf, J., Johnston, R. B., Ambelu, A. B., Arnold, B. F., Bain, R., Brauer, M. D., Brown, J. M., Caruso, B. A., Clasen, T., Colford, J. M., Mills, J. E., Evans, B., Freeman, M. C., Gordon, B. A., Kang, G., Lanata, C. F., Medlicott, K. O., Prüss‐Üstün, A., Troeger, C., … Cumming, O. (2023). Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes. The Lancet, 401(10393), 2060–2071. https://doi.org/10.1016/s0140-6736(23)00458-0
Wolf, Jennyfer, et al. "Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes." The Lancet, vol. 401, no. 10393, 2023, pp. 2060–2071, https://doi.org/10.1016/s0140-6736(23)00458-0.
Wolf, Jennyfer, Richard Bart Johnston, Argaw B. Ambelu, Benjamin F. Arnold, Robert Bain, Michael D Brauer, Joe M. Brown, et al. "Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes." The Lancet 401, no. 10393 (2023): 2060–2071. https://doi.org/10.1016/s0140-6736(23)00458-0.
Wolf J., Johnston R. B., Ambelu A. B. [и др.] Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes // The Lancet. — 2023. — Vol. 401, № 10393. — P. 2060–2071. — URL: https://doi.org/10.1016/s0140-6736(23)00458-0
@article{wolf2023burden,
title = {{Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes}},
author = {Jennyfer Wolf and Richard Bart Johnston and Argaw B. Ambelu and Benjamin F. Arnold and Robert Bain and Michael D Brauer and Joe M. Brown and Bethany A. Caruso and Thomas Clasen and John M. Colford and Joanna Esteves Mills and Barbara Evans and Matthew C. Freeman and Bruce A. Gordon and Gagandeep Kang and Claudio Franco Lanata and Kate O. Medlicott and Annette Prüss‐Üstün and Christopher Troeger and Sophie Boisson and Oliver Cumming},
journal = {The Lancet},
year = {2023},
volume = {401},
number = {10393},
pages = {2060--2071},
doi = {10.1016/s0140-6736(23)00458-0},
url = {https://doi.org/10.1016/s0140-6736(23)00458-0}
}TY - JOUR AU - Wolf, Jennyfer AU - Johnston, Richard Bart AU - Ambelu, Argaw B. AU - Arnold, Benjamin F. AU - Bain, Robert AU - Brauer, Michael D AU - Brown, Joe M. AU - Caruso, Bethany A. AU - Clasen, Thomas AU - Colford, John M. AU - Mills, Joanna Esteves AU - Evans, Barbara AU - Freeman, Matthew C. AU - Gordon, Bruce A. AU - Kang, Gagandeep AU - Lanata, Claudio Franco AU - Medlicott, Kate O. AU - Prüss‐Üstün, Annette AU - Troeger, Christopher AU - Boisson, Sophie AU - Cumming, Oliver TI - Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes JO - The Lancet VL - 401 IS - 10393 SP - 2060 EP - 2071 PY - 2023 DA - 2023/06/01 DO - 10.1016/s0140-6736(23)00458-0 UR - https://doi.org/10.1016/s0140-6736(23)00458-0 ER -
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