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Journal of Global Health Jun 2024Diarrhoeal disease disproportionately affects children <5 years in low- and middle-income countries (LMICs). The pathogens responsible for diarrhoea are commonly... (Meta-Analysis)
Meta-Analysis
Lifestraw Family water filters in low- and middle-income countries: a systematic review and meta-analysis to define longer-term public health impact against childhood diarrhoea and inform scale-up.
BACKGROUND
Diarrhoeal disease disproportionately affects children <5 years in low- and middle-income countries (LMICs). The pathogens responsible for diarrhoea are commonly transmitted through faecally-contaminated drinking water. Lifestraw Family point-of-use water filters have been the subject of intervention studies for over a decade and were the first filters evaluated by the World Health Organization in its water treatment evaluation scheme to provide comprehensive protection against many diarrhoea-causing pathogens. This systematic review aimed to: 1) report on aspects related to physical environment and implementation and 2) conduct an updated meta-analysis on Lifestraw Family filter effectiveness against childhood diarrhoea based on studies with ≥12 months of follow-up.
METHODS
We conducted a literature search in November 2022 using MEDLINE, Embase, Cochrane, and CINAHL databases. Inclusion criteria were: 1) RCTs, cluster-RCTs, quasi-experimental, or matched cohort studies on 2) Lifestraw Family 1.0 or 2.0 filters 3) conducted in LMICs 4) that evaluated filter effectiveness against diarrhoea in children <5 and 5) analysed ≥12 months of follow-up data on clinical effectiveness against diarrhoea and were 6) published from 2010 with 7) full-text availability in English. A modified Newcastle-Ottawa Scale was used to assess risk of bias. Relative risk (RR) and 95% confidence intervals (CIs) were extracted and analysed using a random-effects meta-analysis.
RESULTS
We included 6 studies in LMICs involving 4740 children <5. Of the four clinically-effective interventions, common characteristics were access to improved water sources (75%), the 2.0 version of the filter or the 1.0 version with additional water storage (100%), use of behaviour change theory, community engagement, and health messaging (75%), local filter repair-and-replace mechanisms (75%), and specially-trained local interventionists (100%). The meta-analysis showed a 30% reduction in diarrhoea risk in the intervention group (RR = 0.69; 95% CI = 0.52-0.91, P = 0.01).
CONCLUSIONS
Lifestraw Family water filters can be effective interventions to reduce diarrhoea in vulnerable paediatric populations for at least one year, though certain aspects related to physical environment and implementation may increase their public health impact. The findings of this study suggest considerations for scale-up that can be applied in settings in need of longer-term interim solutions until universal access to safe drinking water is achieved.
Topics: Humans; Diarrhea; Developing Countries; Water Purification; Public Health; Filtration; Child, Preschool; Drinking Water; Infant
PubMed: 38939952
DOI: 10.7189/jogh.14.04018 -
Iranian Journal of Public Health Mar 2024Cadmium, a toxic heavy metal, experienced a surge in production during the 20th century due to the rise of nickel-cadmium batteries, metal plating, and plastic... (Review)
Review
BACKGROUND
Cadmium, a toxic heavy metal, experienced a surge in production during the 20th century due to the rise of nickel-cadmium batteries, metal plating, and plastic stabilizers. Exposure to cadmium primarily occurs through the consumption of contaminated food, such as vegetables and grains, as well as drinking water or inhaling polluted air. The objective of this study was to investigate the relationship between cadmium exposure and the incidence of prostate cancer using a systematic review and meta-analysis approach.
METHODS
This research involved searching and retrieving observational and experimental studies conducted until May 2022 from various databases, including ISI Web of Science, Cochrane, Science Direct, Scopus, Pub-Med, and Google Scholar. Data analysis was performed using Stata 15 statistical software.
RESULTS
The initial search yielded 794 articles, which were subsequently reduced to 427 articles after eliminating duplicates. Following the application of inclusion and exclusion criteria, a total of 16 studies were included in the meta-analysis. The odds ratio of prostate cancer compared to the first quartile of exposure in the second quartile was 1.03 (0.95-1.12), in the third quartile it was 1.12 (0.99-1.26) and in the fourth quartile of exposure was equal to 1.16 (0.79-1.70). Regarding the investigation of the probability of the occurrence of publication bias, the results of Begg's and Egger's tests were not statistically significant.
CONCLUSION
Although exposure to cadmium leads to an increase in the chance of prostate cancer, this chance increase was not statistically significant.
PubMed: 38919294
DOI: 10.18502/ijph.v53i3.15136 -
International Journal of Public Health 2024This systematic review and meta-analysis aimed to: i) determine the pooled prevalence of acute diarrhea; and ii) synthesize and summarize current evidence on factors of... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to: i) determine the pooled prevalence of acute diarrhea; and ii) synthesize and summarize current evidence on factors of acute diarrheal illnesses among under-five children in Ethiopia. A comprehensive systematic search was conducted in PubMed, SCOPUS, HINARI, Science Direct, Google Scholar, Global Index Medicus, Directory of Open Access Journals (DOAJ), and the Cochrane Library. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The methodological quality of each included article was assessed using the Joanna Briggs Institute (JBI) quality assessment tool for cross-sectional and case-control studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of diarrheal illnesses. Heterogeneity and publication bias were assessed using I test statistics and Egger's test, respectively. The statistical analysis was done using STATA™ software version 14. Fifty-three studies covering over 27,458 under-five children who met the inclusion criteria were included. The pooled prevalence of diarrhea among under-five children in Ethiopia was found to be 20.8% (95% CI: 18.69-22.84, n = 44, I = 94.9%, < 0.001). Our analysis revealed a higher prevalence of childhood diarrhea in age groups of 12-23 months 25.42% (95%CI: 21.50-29.35, I = 89.4%, < 0.001). In general, the evidence suggests that diarrheal risk factors could include: i) child level determinants (child's age 0-23 months, not being vaccinated against rotavirus, lack of exclusive breastfeeding, and being an under-nourished child); ii) parental level determinants {mothers poor handwashing practices [pooled odds ratio (OR) = 3.05; 95% CI:2.08-4.54] and a history of maternal recent diarrhea (pooled OR = 3.19, 95%CI: 1.94-5.25)}; and iii) Water, Sanitation and Hygiene (WASH) determinants [lack of toilet facility (pooled OR = 1.56, 95%CI: 1.05-2.33)], lack handwashing facility (pooled OR = 4.16, 95%CI: 2.49-6.95) and not treating drinking water (pooled OR = 2.28, 95% CI: 1.50-3.46). In Ethiopia, the prevalence of diarrhea among children under the age of five remains high and is still a public health problem. The contributing factors to acute diarrheal illnesses were child, parental, and WASH factors. A continued focus on improving access to WASH facilities, along with enhancing maternal hygiene behavior will accelerate reductions in diarrheal disease burden in Ethiopia.
Topics: Humans; Ethiopia; Diarrhea; Child, Preschool; Infant; Prevalence; Observational Studies as Topic; Risk Factors
PubMed: 38903206
DOI: 10.3389/ijph.2024.1606399 -
BMC Oral Health Jun 2024Dental fluorosis (DF) is caused by excessive exposure to fluoride during odontogenesis and leads to various changes in the development of tooth enamel. Some regions in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dental fluorosis (DF) is caused by excessive exposure to fluoride during odontogenesis and leads to various changes in the development of tooth enamel. Some regions in Mexico are considered endemic fluorosis zones due to the high fluoride content in drinking water. The objective of this study was to perform a systematic review and meta-analysis to identify the association between the concentration of fluoride in drinking water and the severity of dental fluorosis in northern and western Mexico.
METHODS
This protocol was registered in the PROSPERO database (ID: CRD42023401519). The search for information was carried out in the PubMed/Medline, Scopus, SpringerLink, and Google Scholar databases between January 2015 and October 2023. The overall relative risk was calculated using the inverse of variance approach with the random effects method. The RoB 2.0 tool was used to construct risk plots.
RESULTS
Eleven articles were analyzed qualitatively, and most of the included studies presented at least one level of DF severity; six articles were analyzed quantitatively, dividing them into two regions. In North region it was observed a higher prevalence of severe TF cases, corresponding to ≥ TF 5 category (4.78) [3.55, 6.42]. In the West region, most of the included studies presented a higher prevalence of less severe cases, corresponding to ≤ TF 4, in comparison with the North region (0.01) [0.00, 0.52], interpreted as a protective effect.
CONCLUSION
The concentrations of fluorides in drinking water are reportedly high in these regions and are directly related to the severity of dental fluorosis experienced by the inhabitants. In the Northern region exists a major concentration of fluoride in drinking water compared with the Western region as well as a prevalence of higher severity cases of dental fluorosis.
Topics: Fluorosis, Dental; Humans; Mexico; Fluorides; Drinking Water; Severity of Illness Index; Prevalence
PubMed: 38898439
DOI: 10.1186/s12903-024-04472-7 -
Microorganisms Apr 2024Pathogenic microorganisms released onto the soil from point or diffuse sources represent a public health concern. They can be transported by rainwater that infiltrates... (Review)
Review
Pathogenic microorganisms released onto the soil from point or diffuse sources represent a public health concern. They can be transported by rainwater that infiltrates into subsoil and reach the groundwater where they can survive for a long time and contaminate drinking water sources. As part of the SCA.Re.S. (Evaluation of Health Risk Related to the Discharge of Wastewater on the Soil) project, we reviewed a selection of field-scale studies that investigated the factors that influenced the fate of microorganisms that were transported from the ground surface to the groundwater. A total of 24 studies published between 2003 and 2022 were included in the review. These studies were selected from the PubMed and Web of Science databases. Microbial contamination of groundwater depends on complex interactions between human activities responsible for the release of contaminants onto the soil, and a range of environmental and biological factors, including the geological, hydraulic, and moisture characteristics of the media traversed by the water, and the characteristics and the viability of the microorganisms, which in turn depend on the environmental conditions and presence of predatory species. Enterococci appeared to be more resistant in the underground environment than thermotolerant coliforms and were suggested as a better indicator for detecting microbial contamination of groundwater.
PubMed: 38792743
DOI: 10.3390/microorganisms12050913 -
Journal of Environmental Management May 2024Hydrogeological effects of climate change will continue to affect water reservoirs worldwide. Some regions are experiencing and will experience severe decline in their...
Hydrogeological effects of climate change will continue to affect water reservoirs worldwide. Some regions are experiencing and will experience severe decline in their water resources due to prolonged periods of drought. Since emergency practices such as the provision of emergency drinking water and forest firefighting depend on regional surface and groundwater resources, the safety of the hydro geosphere's of a region is of fundamental importance, especially in times of crisis. The study uniquely addresses the integration of emergency water management within broader sustainable practices, particularly in the German context where such an analysis has not been previously consolidated. Using the example of emergency drinking water management, the paper elaborates the extent to which measures of emergency response are currently recognised as part of sustainable water management. In an analysis, 79 documents addressing emergency drinking water management of both water supply companies and crisis management authorities in Germany were analysed. The findings revealed a general lack of documents addressing the long-term dependencies between water resources and emergency measures currently applied. Furthermore, the documents do not elaborate on how to implement these measures in a sustainable way recognising the distinctive characteristics of a region. Since response measures can potentially intensify water stress in a region, emergency water management must be consequently included in a holistic water management process to protect landscapes and communities for the future. This paper provides a first comprehensive compilation of essential documents dealing with emergency drinking water management in Germany. It furthermore introduces a new approach to emergency water management and identifies necessary research that could serve as a baseline for future crisis decision making to strengthen national and international initiatives on water resource protection.
Topics: Climate Change; Drinking Water; Germany; Groundwater; Water Supply
PubMed: 38669880
DOI: 10.1016/j.jenvman.2024.120901 -
Nutrients Mar 2024Water consumption is believed to be a key factor in weight management strategies, yet the existing literature on the subject yields inconsistent findings. To... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Water consumption is believed to be a key factor in weight management strategies, yet the existing literature on the subject yields inconsistent findings. To systematically assess the scientific evidence regarding the effect of water intake on adiposity, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) among overweight and obese populations.
METHODS
PubMed and Embase were searched for relevant articles published up to December 2023. The summary weighted mean difference (WMD) and 95% confidence interval (CI) were estimated using the DerSimonian-Laird random-effects model.
RESULTS
In this meta-analysis of eight RCTs, interventions to promote water intake or to substitute water for other beverages as compared to the control group resulted in a summary WMD of -0.33 kg (95% CI = -1.75-1.08, = 78%) for body weight, -0.23 kg/m (95% CI = -0.55-0.09, = 0%) for body mass index (BMI), and 0.05 cm (95% CI = -1.20-1.30, = 40%) for waist circumference (WC). Among RCTs substituting water for artificially sweetened beverages, summary WMD was 1.82 kg (95% CI = 0.97-2.67, = 0%) for body weight and 1.23 cm (95% CI = -0.03-2.48, = 0%) for WC. Conversely, among RCTs substituting water for sugar-sweetened beverages, summary WMD was -0.81 kg (95% CI = -1.66-0.03, = 2%) for body weight and -0.96 cm (95% CI = -2.06-0.13, = 0%) for WC.
CONCLUSIONS
In conclusion, water intake may not significantly impact adiposity among overweight and obese individuals. However, replacing sugar-sweetened beverages with water might offer a modest benefit in inducing weight loss.
Topics: Humans; Overweight; Adiposity; Drinking; Randomized Controlled Trials as Topic; Obesity; Body Weight; Water
PubMed: 38612997
DOI: 10.3390/nu16070963 -
BMC Anesthesiology Apr 2024Early water intake has gained widespread attention considering enhanced recovery after surgery (ERAS). In the present systematic evaluation and meta-analysis, we... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Early water intake has gained widespread attention considering enhanced recovery after surgery (ERAS). In the present systematic evaluation and meta-analysis, we assessed the effects of early water intake on the incidence of vomiting and aspiration in adult patients who received general anaesthesia on regaining consciousness during the resuscitation period.
OBJECTIVE
To systematically analyse the results of randomised controlled trials on early postoperative water intake in patients who underwent different types of surgery under general anaesthesia, both at home and abroad, to further explore the safety and application of early water intake and provide an evidence-based foundation for clinical application.
DESIGN
Systematic review and meta-analysis.
METHODS
To perform the systematic evaluation and meta-analysis, we searched the Web of Science, CINAHL, Embase, PubMed, Cochrane Library, Sinomed, China National Knowledge Infrastructure (CNKI), Wanfang, and Vipshop databases to identify randomised controlled trial studies on early water intake in adult patients who received general anaesthesia.
RESULTS
Herein, we included 10 publications with a total sample size of 5131 patients. Based on statistical analysis, there was no statistically significant difference in the incidence of vomiting (odds ratio [OR] = 0.81; 95% confidence interval [CI] [0.58-1.12]; p = 0.20; I-squared [I] = 0%) and aspiration (OR = 0.78; 95%CI [0.45-1.37]; p = 0.40; I = 0%) between the two groups of patients on regaining consciousness post-general anaesthesia.
CONCLUSION
Based on the available evidence, early water intake after regaining consciousness post-anaesthesia did not increase the incidence of adverse complications when compared with traditional postoperative water abstinence. Early water intake could effectively improve patient thirst and facilitate the recovery of gastrointestinal function.
Topics: Adult; Humans; Drinking; Anesthesia, General; Vomiting; Postoperative Period; China
PubMed: 38594662
DOI: 10.1186/s12871-024-02520-x -
International Journal of Environmental... Mar 2024The prevalence of dementia increases with nearly 10 million new cases each year, with Alzheimer's disease contributing to 60-70% of cases. Environmental factors such as...
The prevalence of dementia increases with nearly 10 million new cases each year, with Alzheimer's disease contributing to 60-70% of cases. Environmental factors such as drinking water have been evaluated to determine if a relationship exists between trace elements in drinking water and the risk of developing cognitive disorders in the elderly. The purpose of the current systematic review was to evaluate an association between the composition of drinking water and cognitive function in the elderly. In accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, a literature search was conducted using PubMed and CINAHL databases. A total of 10 studies were included in the current systematic review. Aluminum is the most commonly evaluated trace element in studies ( = 8), followed by silica ( = 5), calcium ( = 4), and fluoride ( = 4). Aluminum exposure showed an increased risk of cognitive decline in four studies, with no association reported in the other studies. Higher silica and pH levels were shown to be protective against a decline in cognitive function. A similar protective effect of calcium was found in two studies. Future research should measure multiple trace mineral levels in all water sources to evaluate the impact on cognitive function.
Topics: Aged; Humans; Aluminum; Calcium; Cognition; Cognitive Dysfunction; Drinking Water; Silicon Dioxide; Trace Elements
PubMed: 38541362
DOI: 10.3390/ijerph21030362 -
Toxicology Reports Jun 2024PAE and PC polymers, such as BPA, are utilized to make water bottles. Due to the lack of polymer-chemical interaction, PAE can enter drinking bottles during production,... (Review)
Review
PAE and PC polymers, such as BPA, are utilized to make water bottles. Due to the lack of polymer-chemical interaction, PAE can enter drinking bottles during production, wrapping, and keeping. Phthalates can transfer from the bottle to the water depending on keeping conditions (temperature, time, sunlight intensity), pH, and bottle capacity. Since there haven't been previous studies published on the subject, the aim of this meta-analysis and systematic review research is to determine the level of phthalates in drinking water consumed in Iranian cities. Web of Science, Science of Direct, Scopus, and PubMed, databases have been used in this study. Eight studies were selected from 556 initial publications after screening for duplication and irrelevant information. Articles from January 1, 2000, to February 10, 2024, were found in the mentioned databases. Among the types of phthalates, the concentration of DEHP was reported higher than the others Because its concentration has been reported in seven out of eight studies. The highest concentration of DEHP was reported by Mehraie(2.22 µg/l), Zare Jeddi (0.8 µg/l), Yousefi (0.77 µg/l), Abtahi (0.76 µg/l), Zare Jeddi (0.42 µg/l), Abdolahnejad(0.15 µg/l), and Pourzamani (0.08 µg/l). The highest concentration of DEP, DBP, BBP, and PA was reported by Abtahi (0.77 µg/l) and Esteki (2.25 µg/l), Mehraie(0.93 µg/l), and Pourzamani (0.83 µg/l). The results of this study showed that the most important phthalates measured in drinking water include DEP, DEHP, DBP, BBP, and PA. According to the results of the present studies, the most important factor in the increase of phthalates is the storage conditions of drinking water (temperature, sunlight, and the type of pipe or bottle).
PubMed: 38495472
DOI: 10.1016/j.toxrep.2024.02.009