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WASH interventions and child diarrhea at the interface of climate and socioeconomic position in Bangladesh

Author

Listed:
  • Pearl Anne Ante-Testard

    (University of California, San Francisco)

  • Francois Rerolle

    (University of California, San Francisco
    University of California, San Diego)

  • Anna T. Nguyen

    (Stanford University)

  • Sania Ashraf

    (Environmental Health and WASH, Health System and Population Studies Division, icddr,b)

  • Sarker Masud Parvez

    (Environmental Health and WASH, Health System and Population Studies Division, icddr,b
    The University of Queensland)

  • Abu Mohammed Naser

    (University of Memphis)

  • Tarik Benmarhnia

    (University of California, San Diego)

  • Mahbubur Rahman

    (Environmental Health and WASH, Health System and Population Studies Division, icddr,b)

  • Stephen P. Luby

    (Stanford University)

  • Jade Benjamin-Chung

    (Stanford University
    Chan Zuckerberg Biohub)

  • Benjamin F. Arnold

    (University of California, San Francisco)

Abstract

Many diarrhea-causing pathogens are climate-sensitive, and populations with the lowest socioeconomic position (SEP) are often most vulnerable to climate-related transmission. Household Water, Sanitation, and Handwashing (WASH) interventions constitute one potential effective strategy to reduce child diarrhea, especially among low-income households. Capitalizing on a cluster randomized trial population (360 clusters, 4941 children with 8440 measurements) in rural Bangladesh, one of the world’s most climate-sensitive regions, we show that improved WASH substantially reduces diarrhea risk with largest benefits among children with lowest SEP and during the monsoon season. We extrapolated trial results to rural Bangladesh regions using high-resolution geospatial layers to identify areas most likely to benefit. Scaling up a similar intervention could prevent an estimated 734 (95% CI 385, 1085) cases per 1000 children per month during the seasonal monsoon, with marked regional heterogeneities. Here, we show how to extend large-scale trials to inform WASH strategies among climate-sensitive and low-income populations.

Suggested Citation

  • Pearl Anne Ante-Testard & Francois Rerolle & Anna T. Nguyen & Sania Ashraf & Sarker Masud Parvez & Abu Mohammed Naser & Tarik Benmarhnia & Mahbubur Rahman & Stephen P. Luby & Jade Benjamin-Chung & Ben, 2024. "WASH interventions and child diarrhea at the interface of climate and socioeconomic position in Bangladesh," Nature Communications, Nature, vol. 15(1), pages 1-13, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-45624-1
    DOI: 10.1038/s41467-024-45624-1
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    References listed on IDEAS

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    1. Chen, Huey T., 2010. "The bottom-up approach to integrative validity: A new perspective for program evaluation," Evaluation and Program Planning, Elsevier, vol. 33(3), pages 205-214, August.
    2. Imran Ur Rahman & Deng Jian & Liu Junrong & Mohsin Shafi, 2021. "Socio-economic status, resilience, and vulnerability of households under COVID-19: Case of village-level data in Sichuan province," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-22, April.
    3. Young, Robin L. & Weinberg, Janice & Vieira, Verónica & Ozonoff, Al & Webster, Thomas F., 2011. "Generalized additive models and inflated type I error rates of smoother significance tests," Computational Statistics & Data Analysis, Elsevier, vol. 55(1), pages 366-374, January.
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