A systematic review and meta-analysis of the association between self-reported diarrheal disease and distance from home to water source

Abstract

The aim of this study was to identify whether there was a relationship between the distance that people have to carry water home and ill health. We conducted a systematic review for papers that reported on the association between diarrheal risk and distance. Six papers were identified for inclusion in the meta-analysis. These were all observational studies, and only two reported effect sizes that adjusted for possible confounding. Multiple different types of water sources supplied the study communities. The combined odds ratio (OR) showed a significant increase in illness risk in people living farther away from their water source (OR = 1.45; 95% confidence interval [CI] = 1.04-1.68). There is a need for better designed studies to further elucidate the health impacts on having to carry water home.

Figure 1.

Forrest plot of diarrheal disease relative risk with increased distance from water source. The two effect sizes attributed to Tonglet and others relate to different subgroups defined by high- and low-diarrheal illness rates.