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The effectiveness of solar disinfection water treatment method for reducing childhood diarrhea: a systematic review and meta-analysis protocol.

ABSTRACT:

Background

Several studies employing the effectiveness of solar disinfection water treatment method for reducing diarrhea have reported heterogeneous outcomes, necessitating a systematic review to provide an exhaustive summary of current evidence. Thus, the objective of this review is to pool out the available evidence on the effectiveness of solar disinfection water treatment method for reducing childhood diarrhea.

Methods

Searches will be conducted in PubMed/Medline, Scopus, Google Scholar, Cochrane Library databases, and reference of other studies published through in December 2019. Studies that compare the diarrhea incidence among the intervention group who were exposed to solar disinfection water treatment and the control group who were not exposed to such water treatment were included. The primary outcome of the study is the change in observed diarrhea incidence risk from baseline to post-intervention. Randomized controlled trial study designs will be included. Selected studies will be critically appraised by two independent reviewers. Extracted data will include details about the interventions, populations, study methods, and outcomes of significance to the review question and objectives. Effect sizes will be expressed as risk ratio, and their 95% confidence intervals will be calculated for analysis.

Discussion

This review and meta-analysis will systematically explore and integrate the evidence available on the effectiveness of solar disinfection water treatment method for reducing diarrhea. In this review, information about the potential impact of solar disinfection water treatment to inactivate pathogenic microbes for reducing diarrhea will be gathered and summarized. The findings from this study will provide directions for future research and public health professionals with an understanding of the importance of solar disinfection water treatment and point to directions for applicability of the interventions in the community.

SUBMITTER: Soboksa NE

PROVIDER: S-EPMC7017511 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

The effectiveness of solar disinfection water treatment method for reducing childhood diarrhea: a systematic review and meta-analysis protocol.

Soboksa Negasa Eshete NE Gari Sirak Robele SR Hailu Abebe Beyene AB Donacho Dereje Oljira DO Alemu Bezatu Mengistie BM

Systematic reviews 20200212 1

<h4>Background</h4>Several studies employing the effectiveness of solar disinfection water treatment method for reducing diarrhea have reported heterogeneous outcomes, necessitating a systematic review to provide an exhaustive summary of current evidence. Thus, the objective of this review is to pool out the available evidence on the effectiveness of solar disinfection water treatment method for reducing childhood diarrhea.<h4>Methods</h4>Searches will be conducted in PubMed/Medline, Scopus, Goo ...[more]

PMID: 32051039

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Project description:ObjectiveThis study aimed to pool out the available evidence on the effectiveness of the solar disinfection water treatment method for reducing childhood diarrhoea.DesignSystematic review and meta-analysis.SettingGlobal.MethodsSearches were conducted in Medline/PubMed, Scopus, Google Scholar, Cochrane Library databases and references to other studies. The review included all children living anywhere in the world regardless of sex, ethnicity and socioeconomic status published in English until December 2019. Studies that compared the diarrhoea incidence between the intervention group who were exposed to solar disinfection water treatment and the control group who were not exposed to such water treatment were included. The outcome of interest was the change in observed diarrhoea incidence and the risk from baseline to postintervention. Two independent reviewers critically appraised the selected studies. Effect sizes were expressed as risk ratios, and their 95% CIs were calculated for analysis.ResultsWe identified 10 eligible studies conducted in Africa, Latin America and Asia that included 5795 children aged from 1 to 15 years. In all identified studies, solar disinfection reduced the risk of diarrhoea in children, and the effect was statistically significant in eight of the studies. The estimated pooled risk ratio of childhood diarrhoea among participants that used the solar disinfection water treatment method was 0.62 (95% CI 0.53 to 0.72). The overall pooled results indicated that the intervention of solar disinfection water treatment had reduced the risk of childhood diarrhoea by 38%.ConclusionsThe intervention of solar disinfection water treatment significantly reduced the risk of childhood diarrhoea. However, the risk of bias and marked heterogeneity of the included studies precluded definitive conclusions. Further high-quality studies are needed to determine whether solar disinfection water treatment is an important method to reduce childhood diarrhoea.Prospero registration numberCRD42020159243.

Project description:BackgroundSolar drinking water disinfection (SODIS) is a low-cost, point-of-use water purification method that has been disseminated globally. Laboratory studies suggest that SODIS is highly efficacious in inactivating waterborne pathogens. Previous field studies provided limited evidence for its effectiveness in reducing diarrhoea.Methods and findingsWe conducted a cluster-randomized controlled trial in 22 rural communities in Bolivia to evaluate the effect of SODIS in reducing diarrhoea among children under the age of 5 y. A local nongovernmental organisation conducted a standardised interactive SODIS-promotion campaign in 11 communities targeting households, communities, and primary schools. Mothers completed a daily child health diary for 1 y. Within the intervention arm 225 households (376 children) were trained to expose water-filled polyethyleneteraphtalate bottles to sunlight. Eleven communities (200 households, 349 children) served as a control. We recorded 166,971 person-days of observation during the trial representing 79.9% and 78.9% of the total possible person-days of child observation in intervention and control arms, respectively. Mean compliance with SODIS was 32.1%. The reported incidence rate of gastrointestinal illness in children in the intervention arm was 3.6 compared to 4.3 episodes/year at risk in the control arm. The relative rate of diarrhoea adjusted for intracluster correlation was 0.81 (95% confidence interval 0.59-1.12). The median length of diarrhoea was 3 d in both groups.ConclusionsDespite an extensive SODIS promotion campaign we found only moderate compliance with the intervention and no strong evidence for a substantive reduction in diarrhoea among children. These results suggest that there is a need for better evidence of how the well-established laboratory efficacy of this home-based water treatment method translates into field effectiveness under various cultural settings and intervention intensities. Further global promotion of SODIS for general use should be undertaken with care until such evidence is available.Trial registrationwww.ClinicalTrials.govNCT00731497 Please see later in the article for Editors' Summary.

Project description:Diarrhoea is the second leading cause of childhood mortality, with an estimated 1.3 million deaths per year. Promotion of Solar Water Disinfection (SODIS) has been suggested as a strategy for reducing the global burden of diarrhoea by improving the microbiological quality of drinking water. Despite increasing support for the large-scale dissemination of SODIS, there are few reports describing the effectiveness of its implementation. It is, therefore, important to identify and understand the mechanisms that lead to adoption and regular use of SODIS.We investigated the behaviours associated with SODIS adoption among households assigned to receive SODIS promotion during a cluster-randomized trial in rural Bolivia. Distinct groups of SODIS-users were identified on the basis of six compliance indicators using principal components and cluster analysis. The probability of adopting SODIS as a function of campaign exposure and household characteristics was evaluated using ordinal logistic regression models.Standardised, community-level SODIS-implementation in a rural Bolivian setting was associated with a median SODIS use of 32% (IQR: 17-50). Households that were more likely to use SODIS were those that participated more frequently in SODIS promotional events (OR=1.07, 95%CI: 1.01-1.13), included women (OR=1.18, 95%CI: 1.07-1.30), owned latrines (OR=3.38, 95%CI: 1.07-10.70), and had severely wasted children living in the home (OR=2.17, 95%CI: 1.34-3.49).Most of the observed household characteristics showed limited potential to predict compliance with a comprehensive, year-long SODIS-promotion campaign; this finding reflects the complexity of behaviour change in the context of household water treatment. However, our findings also suggest that the motivation to adopt new water treatment habits and to acquire new knowledge about drinking water treatment is associated with prior engagements in sanitary hygiene and with the experience of contemporary family health concerns.Household-level factors like the ownership of a latrine, a large proportion of females and the presence of a malnourished child living in a home are easily assessable indicators that SODIS-programme managers could use to identify early adopters in SODIS promotion campaigns.ClinicalTrials.gov: NCT00731497.

Project description:Despite the increasing volume of evidence demonstrating the efficacy of solar water disinfection (SODIS) as a household water treatment technology, there still appear to be significant barriers to uptake in developing countries. The potential of SODIS is often treated with skepticism in terms of effective treatment, volume, and safety, and is dismissed in preference for more accepted technologies such as ceramic filters and dose chlorination. As part of WATERSPOUTT (EU H2020 688928), our study used a transdisciplinary methodology to cocreate an innovative SODIS system in rural Malawi. The formative work focused on the design of 1) an appropriate and acceptable system and 2) a context-specific intervention delivery program using a behavior-centered design. Initial research identified specific water needs and challenges, which were discussed along with a cocreation process with potential end users, through a series of shared dialogue workshops (SDWs). Specifications from end users outlined a desire for higher volume systems (20 L) that were "familiar" and could be manufactured locally. Development of the "SODIS bucket" was then undertaken by design experts and local manufacturers, with input from end users and subject to controlled testing to ensure efficacy and safety. Concurrent data were collated using questionnaires (n = 777 households), water point mapping (n = 121), water quality testing (n = 46), and behavior change modeling (n = 100 households). These identified specific contextual issues (hydrogeology, water access, gender roles, social capital, and socioeconomic status), and behavioral determinants (normative, ability, and self-regulation factors) that informed the development and delivery mechanism for the implementation toolkit. Integr Environ Assess Manag 2020;16:871-884. © 2020 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Project description:BackgroundChinese medicine belly button application (CMBBA) has been used to treat childhood diarrhea (CD) in several randomized controlled trials (RCTs), but its effectiveness and combination strategy still need to be clarified. Therefore, we aimed to evaluate the effectiveness, safety, and the optimal combination strategy of CMBBA in treating CD.MethodsUp until January 2023, we searched for studies that met our inclusion criteria in six databases, including PubMed, the Cochrane Library, Chinese SinoMed, CNKI, VIP, and Wanfang. Heterogeneity was quantified using I2 statistics. A methodological evaluation was performed using the Cochrane Risk Bias Tool 2.0. The Confidence in Network Meta-Analysis online software was employed to evaluate evidence grading. A minimally contextualized framework was used to provide a comprehensive conclusion for the network meta-analysis. This study protocol was registered with PROSPERO.ResultsWe analyzed data from 33 RCTs that included 4,490 children with diarrhea. In terms of clinical effectiveness, CMBBA plus montmorillonite powder plus anti-infectives may be the most effective treatment option for children with diarrhea and concurrent infection according to a minimally contextualized framework. Either exclusive use of CMBBA or CMBBA in combination with modern medicine was beneficial in reducing the time to diarrhea disappearance (MD = -1.33 days, 95% CI: -1.59 to -1.08, Z = -10.103, p < 0.001) compared to modern medicine exclusively, and the difference was statistically significant. The combined usage of CMBBA could shorten the recovery time of dehydration by an average of 0.74 days (MD = -0.74 days, 95% CI: -1.10 to -0.37, Z = -3.931.103, p < 0.001). While some studies have reported mild allergic reactions and mild abdominal pain after CMBBA use, these symptoms can be cured in a relatively short period of time.ConclusionsThe combination of CMBBA, montmorillonite powder, and anti-infectives may provide superior clinical effectiveness for children with diarrhea and concurrent infection. To treat CD, CMBBA can be used effectively and safely. However, the findings must be interpreted with cautiously due to the limited number of clinical trials and the low quality of the studies. In addition, the choice of treatment plan should also be based on the specific conditions of each patient.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022380694.

Dataset Information

The effectiveness of solar disinfection water treatment method for reducing childhood diarrhea: a systematic review and meta-analysis protocol.

Background

Methods

Discussion

Publications

The effectiveness of solar disinfection water treatment method for reducing childhood diarrhea: a systematic review and meta-analysis protocol.

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