Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis
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{"title"=>"Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Eric C.", "last_name"=>"Strunz", "scopus_author_id"=>"56122527500"}, {"first_name"=>"David G.", "last_name"=>"Addiss", "scopus_author_id"=>"7005696197"}, {"first_name"=>"Meredith E.", "last_name"=>"Stocks", "scopus_author_id"=>"56057711400"}, {"first_name"=>"Stephanie", "last_name"=>"Ogden", "scopus_author_id"=>"55643460000"}, {"first_name"=>"Jürg", "last_name"=>"Utzinger", "scopus_author_id"=>"7003667858"}, {"first_name"=>"Matthew C.", "last_name"=>"Freeman", "scopus_author_id"=>"23099628300"}], "year"=>2014, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491676", "scopus"=>"2-s2.0-84898949931", "sgr"=>"84898949931", "pui"=>"372909850", "isbn"=>"1549-1676", "pmid"=>"24667810", "doi"=>"10.1371/journal.pmed.1001620"}, "id"=>"8aeacbdd-876f-3468-ac4c-317dd2cdb0f2", "abstract"=>"BACKGROUND: Preventive chemotherapy represents a powerful but short-term control strategy for soil-transmitted helminthiasis. Since humans are often re-infected rapidly, long-term solutions require improvements in water, sanitation, and hygiene (WASH). The purpose of this study was to quantitatively summarize the relationship between WASH access or practices and soil-transmitted helminth (STH) infection.\\n\\nMETHODS AND FINDINGS: We conducted a systematic review and meta-analysis to examine the associations of improved WASH on infection with STH (Ascaris lumbricoides, Trichuris trichiura, hookworm [Ancylostoma duodenale and Necator americanus], and Strongyloides stercoralis). PubMed, Embase, Web of Science, and LILACS were searched from inception to October 28, 2013 with no language restrictions. Studies were eligible for inclusion if they provided an estimate for the effect of WASH access or practices on STH infection. We assessed the quality of published studies with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. A total of 94 studies met our eligibility criteria; five were randomized controlled trials, whilst most others were cross-sectional studies. We used random-effects meta-analyses and analyzed only adjusted estimates to help account for heterogeneity and potential confounding respectively. Use of treated water was associated with lower odds of STH infection (odds ratio [OR] 0.46, 95% CI 0.36-0.60). Piped water access was associated with lower odds of A. lumbricoides (OR 0.40, 95% CI 0.39-0.41) and T. trichiura infection (OR 0.57, 95% CI 0.45-0.72), but not any STH infection (OR 0.93, 95% CI 0.28-3.11). Access to sanitation was associated with decreased likelihood of infection with any STH (OR 0.66, 95% CI 0.57-0.76), T. trichiura (OR 0.61, 95% CI 0.50-0.74), and A. lumbricoides (OR 0.62, 95% CI 0.44-0.88), but not with hookworm infection (OR 0.80, 95% CI 0.61-1.06). Wearing shoes was associated with reduced odds of hookworm infection (OR 0.29, 95% CI 0.18-0.47) and infection with any STH (OR 0.30, 95% CI 0.11-0.83). Handwashing, both before eating (OR 0.38, 95% CI 0.26-0.55) and after defecating (OR 0.45, 95% CI 0.35-0.58), was associated with lower odds of A. lumbricoides infection. Soap use or availability was significantly associated with lower infection with any STH (OR 0.53, 95% CI 0.29-0.98), as was handwashing after defecation (OR 0.47, 95% CI 0.24-0.90). Observational evidence constituted the majority of included literature, which limits any attempt to make causal inferences. Due to underlying heterogeneity across observational studies, the meta-analysis results reflect an average of many potentially distinct effects, not an average of one specific exposure-outcome relationship.\\n\\nCONCLUSIONS: WASH access and practices are generally associated with reduced odds of STH infection. Pooled estimates from all meta-analyses, except for two, indicated at least a 33% reduction in odds of infection associated with individual WASH practices or access. Although most WASH interventions for STH have focused on sanitation, access to water and hygiene also appear to significantly reduce odds of infection. Overall quality of evidence was low due to the preponderance of observational studies, though recent randomized controlled trials have further underscored the benefit of handwashing interventions. Limited use of the Joint Monitoring Program's standardized water and sanitation definitions in the literature restricted efforts to generalize across studies. While further research is warranted to determine the magnitude of benefit from WASH interventions for STH control, these results call for multi-sectoral, integrated intervention packages that are tailored to social-ecological contexts.", "link"=>"http://www.mendeley.com/research/water-sanitation-hygiene-soiltransmitted-helminth-infection-systematic-review-metaanalysis-11", "reader_count"=>321, "reader_count_by_academic_status"=>{"Unspecified"=>7, "Professor > Associate Professor"=>7, "Student > Doctoral Student"=>17, "Researcher"=>52, "Student > Ph. D. Student"=>46, "Student > Postgraduate"=>24, "Student > Master"=>92, "Other"=>15, "Student > Bachelor"=>45, "Lecturer"=>9, "Lecturer > Senior Lecturer"=>1, "Professor"=>6}, "reader_count_by_user_role"=>{"Unspecified"=>7, "Professor > Associate Professor"=>7, "Student > Doctoral Student"=>17, "Researcher"=>52, "Student > Ph. D. Student"=>46, "Student > Postgraduate"=>24, "Student > Master"=>92, "Other"=>15, "Student > Bachelor"=>45, "Lecturer"=>9, "Lecturer > Senior Lecturer"=>1, "Professor"=>6}, "reader_count_by_subject_area"=>{"Unspecified"=>18, "Agricultural and Biological Sciences"=>53, "Arts and Humanities"=>2, "Business, Management and Accounting"=>6, "Veterinary Science and Veterinary Medicine"=>3, "Chemical Engineering"=>1, "Chemistry"=>2, "Computer Science"=>1, "Earth and Planetary Sciences"=>1, "Economics, Econometrics and Finance"=>2, "Engineering"=>16, "Environmental Science"=>32, "Nursing and Health Professions"=>17, "Biochemistry, Genetics and Molecular Biology"=>8, "Materials Science"=>1, "Medicine and Dentistry"=>100, "Neuroscience"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>3, "Sports and Recreations"=>2, "Psychology"=>9, "Social Sciences"=>34, "Immunology and Microbiology"=>9}, "reader_count_by_subdiscipline"=>{"Materials Science"=>{"Materials Science"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>100}, "Social Sciences"=>{"Social Sciences"=>34}, "Sports and Recreations"=>{"Sports and Recreations"=>2}, "Psychology"=>{"Psychology"=>9}, "Unspecified"=>{"Unspecified"=>18}, "Environmental Science"=>{"Environmental Science"=>32}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>3}, "Chemical Engineering"=>{"Chemical Engineering"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>2}, "Engineering"=>{"Engineering"=>16}, "Chemistry"=>{"Chemistry"=>2}, "Neuroscience"=>{"Neuroscience"=>1}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>9}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>53}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>6}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>17}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>8}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>3}}, "reader_count_by_country"=>{"Netherlands"=>1, "Argentina"=>1, "United States"=>3, "Tanzania"=>1, "Rwanda"=>1, "Brazil"=>2, "United Kingdom"=>2, "Australia"=>1, "Peru"=>1, "Indonesia"=>1, "Spain"=>1}, "group_count"=>20}

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  • {"files"=>["https://ndownloader.figshare.com/files/1434714"], "description"=>"a<p>Studies contributed to a meta-analysis.</p><p>HAZ, height for age Z score; SES, socioeconomic status.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "included", "studies", "authors"], "article_id"=>973928, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t005", "stats"=>{"downloads"=>5, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_List_of_included_studies_with_authors_N_8211_Z_/973928", "title"=>"List of included studies with authors N–Z.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434678"], "description"=>"<p>Meta-analysis of the association between use of piped water use and any STH infection <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Belyhun1\" target=\"_blank\">[70]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Wordemann1\" target=\"_blank\">[97]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Roy1\" target=\"_blank\">[114]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Ivan1\" target=\"_blank\">[116]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "piped", "sth"], "article_id"=>973908, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g004", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_use_of_piped_water_use_and_any_STH_infection_70_97_114_116_/973908", "title"=>"Meta-analysis of the association between use of piped water use and any STH infection [70],[97],[114]–[116].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434675"], "description"=>"<p>PRISMA flow diagram.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis"], "article_id"=>973905, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_PRISMA_flow_diagram_/973905", "title"=>"PRISMA flow diagram.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434717"], "description"=>"<p>Cells with high numbers but no meta-analysis (no footnote) indicate that effect measures were not reported (selective reporting), reported measures were not statistically adjusted, or that the WASH access and practice was too diverse to be effectively grouped in a meta-analysis (e.g., handwashing can be measured before eating or after defecating).</p>a<p>Water Types and Latrine Types refer to studies that measured multiple sanitation comparisons, not just “latrine versus no latrine.” For example, a study could examine water collected from rivers, wells, or piped connections.</p>b<p>Gray cells indicate that a meta-analysis was conducted for that WASH variable and STH outcome.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "studies", "investigated", "sth"], "article_id"=>973931, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t007", "stats"=>{"downloads"=>2, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_studies_that_investigated_STH_species_and_WASH_access_and_practices_/973931", "title"=>"Number of studies that investigated STH species and WASH access and practices.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434681"], "description"=>"<p>Meta-analysis of the association between sanitation access and infection with any STH <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Wordemann1\" target=\"_blank\">[97]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Ahmed1\" target=\"_blank\">[111]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Wang2\" target=\"_blank\">[112]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Roy1\" target=\"_blank\">[114]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-PhamDuc1\" target=\"_blank\">[115]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Stothard1\" target=\"_blank\">[120]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Hidayah1\" target=\"_blank\">[122]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "sanitation", "sth"], "article_id"=>973911, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g007", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_sanitation_access_and_infection_with_any_STH_97_111_112_114_115_120_122_/973911", "title"=>"Meta-analysis of the association between sanitation access and infection with any STH [97],[111],[112],[114],[115],[120]–[122].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434710"], "description"=>"<p>Criteria for study bias assessment.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis"], "article_id"=>973924, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t001", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Criteria_for_study_bias_assessment_/973924", "title"=>"Criteria for study bias assessment.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434707"], "description"=>"<p>Meta-analysis of the association between handwashing after defecation and infection with any STH <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Hughes1\" target=\"_blank\">[73]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Hohmann1\" target=\"_blank\">[80]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Wang2\" target=\"_blank\">[112]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Ivan1\" target=\"_blank\">[116]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Balen2\" target=\"_blank\">[131]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "handwashing", "defecation", "sth"], "article_id"=>973921, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g014", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_handwashing_after_defecation_and_infection_with_any_STH_73_80_112_116_131_/973921", "title"=>"Meta-analysis of the association between handwashing after defecation and infection with any STH [73],[80],[112],[116],[131].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434700"], "description"=>"<p>Meta-analysis of the association between sanitation access and <i>T. trichiura</i> infection <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Young1\" target=\"_blank\">[82]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Narain1\" target=\"_blank\">[84]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Wordemann1\" target=\"_blank\">[97]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-PhamDuc1\" target=\"_blank\">[115]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Corrales1\" target=\"_blank\">[124]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Schmidlin1\" target=\"_blank\">[126]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "sanitation"], "article_id"=>973914, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g009", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_sanitation_access_and_T_trichiura_infection_82_84_97_115_124_126_/973914", "title"=>"Meta-analysis of the association between sanitation access and <i>T. trichiura</i> infection [82],[84],[97],[115],[124]–[126].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434713"], "description"=>"a<p>Studies contributed to a meta-analysis.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "included", "studies", "authors"], "article_id"=>973927, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t004", "stats"=>{"downloads"=>6, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_List_of_included_studies_with_authors_G_8211_M_/973927", "title"=>"List of included studies with authors G–M.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434703"], "description"=>"<p>Meta-analysis of the association between soap use and infection with any STH <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Belyhun1\" target=\"_blank\">[70]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Hughes1\" target=\"_blank\">[73]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Parajuli1\" target=\"_blank\">[129]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "sth"], "article_id"=>973917, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g011", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_soap_use_and_infection_with_any_STH_70_73_129_/973917", "title"=>"Meta-analysis of the association between soap use and infection with any STH [70],[73],[129].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434716"], "description"=>"<p>Each cell indicates the number of reviewed studies that investigated both an STH species (or any STH) and WASH domains. Higher numbers suggest that certain WASH-STH relationships are more commonly explored in the literature.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "studies", "investigated", "sth"], "article_id"=>973930, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t006", "stats"=>{"downloads"=>2, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_studies_n_94_that_investigated_STH_species_and_WASH_domains_/973930", "title"=>"Number of studies (<i>n</i> = 94) that investigated STH species and WASH domains.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434680"], "description"=>"<p>Meta-analysis of the association between use of piped water and <i>T. trichiura</i> infection <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-PhamDuc1\" target=\"_blank\">[115]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Traub1\" target=\"_blank\">[118]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Fonseca1\" target=\"_blank\">[119]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "piped"], "article_id"=>973910, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g006", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_use_of_piped_water_and_T_trichiura_infection_115_118_119_/973910", "title"=>"Meta-analysis of the association between use of piped water and <i>T. trichiura</i> infection [115],[118],[119].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434677"], "description"=>"<p>Meta-analysis of the association between use of treated water and infection with any STH <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Ahmed1\" target=\"_blank\">[111]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Aimpun1\" target=\"_blank\">[113]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "treated", "sth"], "article_id"=>973907, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g003", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_use_of_treated_water_and_infection_with_any_STH_111_113_/973907", "title"=>"Meta-analysis of the association between use of treated water and infection with any STH [111]–[113].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434706"], "description"=>"<p>Meta-analysis of the association between handwashing after defecation and infection with <i>A. lumbricoides</i><a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Nasr1\" target=\"_blank\">[66]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Hohmann1\" target=\"_blank\">[80]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Ivan1\" target=\"_blank\">[116]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "handwashing", "defecation"], "article_id"=>973920, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g013", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_handwashing_after_defecation_and_infection_with_A_lumbricoides_66_80_116_/973920", "title"=>"Meta-analysis of the association between handwashing after defecation and infection with <i>A. lumbricoides</i>[66],[80],[116].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434719"], "description"=>"<p>Meta-analysis grades.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis"], "article_id"=>973933, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t009", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_grades_/973933", "title"=>"Meta-analysis grades.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434712"], "description"=>"a<p>Studies contributed to a meta-analysis.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "included", "studies", "authors"], "article_id"=>973926, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t003", "stats"=>{"downloads"=>2, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_List_of_included_studies_with_authors_A_8211_F_/973926", "title"=>"List of included studies with authors A–F.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434709"], "description"=>"<p>Meta-analysis of the association between wearing shoes and infection with any STH <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Ahmed1\" target=\"_blank\">[111]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Parajuli1\" target=\"_blank\">[129]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Phiri1\" target=\"_blank\">[134]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "wearing", "shoes", "sth"], "article_id"=>973923, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g016", "stats"=>{"downloads"=>1, "page_views"=>17, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_wearing_shoes_and_infection_with_any_STH_111_129_134_/973923", "title"=>"Meta-analysis of the association between wearing shoes and infection with any STH [111],[129],[134].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434702"], "description"=>"<p>Meta-analysis of the association between sanitation access and hookworm infection <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Chongsuvivatwong1\" target=\"_blank\">[65]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Corrales1\" target=\"_blank\">[124]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Schmidlin1\" target=\"_blank\">[126]</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Mihrshahi1\" target=\"_blank\">[128]</a>. Note: Chongsuvivatwong et al <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Chongsuvivatwong1\" target=\"_blank\">[65]</a>. reported on two separate studies in their 1996 article.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "sanitation", "hookworm", "chongsuvivatwong", "et", "al", "studies", "1996"], "article_id"=>973916, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g010", "stats"=>{"downloads"=>2, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_sanitation_access_and_hookworm_infection_65_124_126_128_Note_Chongsuvivatwong_et_al_65_reported_on_two_separate_studies_in_their_1996_article_/973916", "title"=>"Meta-analysis of the association between sanitation access and hookworm infection [65],[124],[126]–[128]. Note: Chongsuvivatwong et al [65]. reported on two separate studies in their 1996 article.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434684"], "description"=>"<p>Meta-analysis of the association between sanitation access and <i>A. lumbricoides</i> infection <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Nasr1\" target=\"_blank\">[66]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Young1\" target=\"_blank\">[82]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-PhamDuc1\" target=\"_blank\">[115]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Do1\" target=\"_blank\">[121]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Asaolu2\" target=\"_blank\">[123]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Corrales1\" target=\"_blank\">[124]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "sanitation"], "article_id"=>973913, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g008", "stats"=>{"downloads"=>0, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_sanitation_access_and_A_lumbricoides_infection_66_82_115_121_123_124_/973913", "title"=>"Meta-analysis of the association between sanitation access and <i>A. lumbricoides</i> infection [66],[82],[115],[121],[123],[124].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434676"], "description"=>"<p>Retrieved articles by WASH group.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "articles"], "article_id"=>973906, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g002", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Retrieved_articles_by_WASH_group_/973906", "title"=>"Retrieved articles by WASH group.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434705"], "description"=>"<p>Meta-analysis of the association between handwashing before eating and infection with <i>A. lumbricoides</i><a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Hohmann1\" target=\"_blank\">[80]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Knopp2\" target=\"_blank\">[125]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Gunawardena1\" target=\"_blank\">[130]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "handwashing"], "article_id"=>973919, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g012", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_handwashing_before_eating_and_infection_with_A_lumbricoides_80_125_130_/973919", "title"=>"Meta-analysis of the association between handwashing before eating and infection with <i>A. lumbricoides</i>[80],[125],[130].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434718"], "description"=>"<p>Meta-analysis results.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis"], "article_id"=>973932, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t008", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_results_/973932", "title"=>"Meta-analysis results.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434679"], "description"=>"<p>Meta-analysis of the association between use of piped water and <i>A. lumbricoides</i> infection <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Nasr1\" target=\"_blank\">[66]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Quintero1\" target=\"_blank\">[69]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Steinmann1\" target=\"_blank\">[79]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-MoralesEspinoza1\" target=\"_blank\">[117]</a>.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "piped"], "article_id"=>973909, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g005", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_use_of_piped_water_and_A_lumbricoides_infection_66_69_79_117_/973909", "title"=>"Meta-analysis of the association between use of piped water and <i>A. lumbricoides</i> infection [66],[69],[79],[117].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434708"], "description"=>"<p>Meta-analysis of the association between wearing shoes and hookworm infection <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Chongsuvivatwong1\" target=\"_blank\">[65]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Traub1\" target=\"_blank\">[118]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Humphries1\" target=\"_blank\">[132]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Jiraanankul1\" target=\"_blank\">[133]</a>. Note: Chongsuvivatwong et al. <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001620#pmed.1001620-Chongsuvivatwong1\" target=\"_blank\">[65]</a> reported on two separate studies in their 1996 article.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "wearing", "shoes", "hookworm", "chongsuvivatwong", "et", "studies", "1996"], "article_id"=>973922, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.g015", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_the_association_between_wearing_shoes_and_hookworm_infection_65_118_132_133_Note_Chongsuvivatwong_et_al_65_reported_on_two_separate_studies_in_their_1996_article_/973922", "title"=>"Meta-analysis of the association between wearing shoes and hookworm infection [65],[118],[132],[133]. Note: Chongsuvivatwong et al. [65] reported on two separate studies in their 1996 article.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434721", "https://ndownloader.figshare.com/files/1434722", "https://ndownloader.figshare.com/files/1434723", "https://ndownloader.figshare.com/files/1434724", "https://ndownloader.figshare.com/files/1434725", "https://ndownloader.figshare.com/files/1434726", "https://ndownloader.figshare.com/files/1434727", "https://ndownloader.figshare.com/files/1434728", "https://ndownloader.figshare.com/files/1434729", "https://ndownloader.figshare.com/files/1434730", "https://ndownloader.figshare.com/files/1434731", "https://ndownloader.figshare.com/files/1434732", "https://ndownloader.figshare.com/files/1434733", "https://ndownloader.figshare.com/files/1434734", "https://ndownloader.figshare.com/files/1434735", "https://ndownloader.figshare.com/files/1434736", "https://ndownloader.figshare.com/files/1434737", "https://ndownloader.figshare.com/files/1434738", "https://ndownloader.figshare.com/files/1434739"], "description"=>"<div><p>Background</p><p>Preventive chemotherapy represents a powerful but short-term control strategy for soil-transmitted helminthiasis. Since humans are often re-infected rapidly, long-term solutions require improvements in water, sanitation, and hygiene (WASH). The purpose of this study was to quantitatively summarize the relationship between WASH access or practices and soil-transmitted helminth (STH) infection.</p><p>Methods and Findings</p><p>We conducted a systematic review and meta-analysis to examine the associations of improved WASH on infection with STH (<i>Ascaris lumbricoides</i>, <i>Trichuris trichiura</i>, hookworm [<i>Ancylostoma duodenale</i> and <i>Necator americanus</i>], and <i>Strongyloides stercoralis</i>). PubMed, Embase, Web of Science, and LILACS were searched from inception to October 28, 2013 with no language restrictions. Studies were eligible for inclusion if they provided an estimate for the effect of WASH access or practices on STH infection. We assessed the quality of published studies with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. A total of 94 studies met our eligibility criteria; five were randomized controlled trials, whilst most others were cross-sectional studies. We used random-effects meta-analyses and analyzed only adjusted estimates to help account for heterogeneity and potential confounding respectively.</p><p>Use of treated water was associated with lower odds of STH infection (odds ratio [OR] 0.46, 95% CI 0.36–0.60). Piped water access was associated with lower odds of <i>A. lumbricoides</i> (OR 0.40, 95% CI 0.39–0.41) and <i>T. trichiura</i> infection (OR 0.57, 95% CI 0.45–0.72), but not any STH infection (OR 0.93, 95% CI 0.28–3.11). Access to sanitation was associated with decreased likelihood of infection with any STH (OR 0.66, 95% CI 0.57–0.76), <i>T. trichiura</i> (OR 0.61, 95% CI 0.50–0.74), and <i>A. lumbricoides</i> (OR 0.62, 95% CI 0.44–0.88), but not with hookworm infection (OR 0.80, 95% CI 0.61–1.06). Wearing shoes was associated with reduced odds of hookworm infection (OR 0.29, 95% CI 0.18–0.47) and infection with any STH (OR 0.30, 95% CI 0.11–0.83). Handwashing, both before eating (OR 0.38, 95% CI 0.26–0.55) and after defecating (OR 0.45, 95% CI 0.35–0.58), was associated with lower odds of <i>A. lumbricoides</i> infection. Soap use or availability was significantly associated with lower infection with any STH (OR 0.53, 95% CI 0.29–0.98), as was handwashing after defecation (OR 0.47, 95% CI 0.24–0.90).</p><p>Observational evidence constituted the majority of included literature, which limits any attempt to make causal inferences. Due to underlying heterogeneity across observational studies, the meta-analysis results reflect an average of many potentially distinct effects, not an average of one specific exposure-outcome relationship.</p><p>Conclusions</p><p>WASH access and practices are generally associated with reduced odds of STH infection. Pooled estimates from all meta-analyses, except for two, indicated at least a 33% reduction in odds of infection associated with individual WASH practices or access. Although most WASH interventions for STH have focused on sanitation, access to water and hygiene also appear to significantly reduce odds of infection. Overall quality of evidence was low due to the preponderance of observational studies, though recent randomized controlled trials have further underscored the benefit of handwashing interventions. Limited use of the Joint Monitoring Program's standardized water and sanitation definitions in the literature restricted efforts to generalize across studies. While further research is warranted to determine the magnitude of benefit from WASH interventions for STH control, these results call for multi-sectoral, integrated intervention packages that are tailored to social-ecological contexts.</p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "soil-transmitted", "helminth", "systematic"], "article_id"=>973935, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001620.s001", "https://dx.doi.org/10.1371/journal.pmed.1001620.s002", "https://dx.doi.org/10.1371/journal.pmed.1001620.s003", "https://dx.doi.org/10.1371/journal.pmed.1001620.s004", "https://dx.doi.org/10.1371/journal.pmed.1001620.s005", "https://dx.doi.org/10.1371/journal.pmed.1001620.s006", "https://dx.doi.org/10.1371/journal.pmed.1001620.s007", "https://dx.doi.org/10.1371/journal.pmed.1001620.s008", "https://dx.doi.org/10.1371/journal.pmed.1001620.s009", "https://dx.doi.org/10.1371/journal.pmed.1001620.s010", "https://dx.doi.org/10.1371/journal.pmed.1001620.s011", "https://dx.doi.org/10.1371/journal.pmed.1001620.s012", "https://dx.doi.org/10.1371/journal.pmed.1001620.s013", "https://dx.doi.org/10.1371/journal.pmed.1001620.s014", "https://dx.doi.org/10.1371/journal.pmed.1001620.s015", "https://dx.doi.org/10.1371/journal.pmed.1001620.s016", "https://dx.doi.org/10.1371/journal.pmed.1001620.s017", "https://dx.doi.org/10.1371/journal.pmed.1001620.s018", "https://dx.doi.org/10.1371/journal.pmed.1001620.s019"], "stats"=>{"downloads"=>16, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Water_Sanitation_Hygiene_and_Soil_Transmitted_Helminth_Infection_A_Systematic_Review_and_Meta_Analysis_/973935", "title"=>"Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-03-25 03:44:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/1434711"], "description"=>"<p>Criteria for meta-analysis GRADE assessment.</p>", "links"=>[], "tags"=>["mathematics", "Statistics (mathematics)", "Confidence intervals", "epidemiology", "Infectious disease epidemiology", "Public and occupational health", "Global health", "Infectious diseases", "Parasitic diseases", "Helminth infections", "Soil-transmitted helminthiases", "ascariasis", "Hookworm diseases", "strongyloidiasis", "trichuriasis", "meta-analysis"], "article_id"=>973925, "categories"=>["Biological Sciences"], "users"=>["Eric C. Strunz", "David G. Addiss", "Meredith E. Stocks", "Stephanie Ogden", "Jürg Utzinger", "Matthew C. Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001620.t002", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Criteria_for_meta_analysis_GRADE_assessment_/973925", "title"=>"Criteria for meta-analysis GRADE assessment.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-03-25 03:44:34"}

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