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

Author:

Ante-Testard Pearl AnneORCID,Rerolle Francois,Nguyen Anna T.,Ashraf Sania,Parvez Sarker Masud,Naser Abu Mohammed,Benmarhnia Tarik,Rahman MahbuburORCID,Luby Stephen P.ORCID,Benjamin-Chung JadeORCID,Arnold Benjamin F.ORCID

Abstract

AbstractMany 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.

Funder

U.S. Department of Health & Human Services | NIH | National Institute of Allergy and Infectious Diseases

Bill and Melinda Gates Foundation

Publisher

Springer Science and Business Media LLC

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