Increased latrine coverage not the only solution for India's sanitation problems: Lancet

A new study has revealed that increased latrine coverage is not the only solution for reducing exposure to faecal pathogens and preventing disease, as efforts to improve sanitation should also be implemented in a way that achieves uptake, reduces exposure, and delivers genuine health gains.

The study aimed to assess the effectiveness of a rural sanitation intervention, within the context of the Government of India's Total Sanitation Campaign, to prevent diarrhoea, soil-transmitted helminth infection, and child malnutrition.

The scientists conducting a cluster-randomised trial in 100 rural villages in Odisha, India randomly assigned 50 villages to the intervention group and 50 villages to the control group. There were 4586 households (24 969 individuals) in intervention villages and 4894 households (25 982 individuals) in control villages.

The intervention increased mean village-level latrine coverage from 9% of households to 63%, compared with an increase from 8 percent to 12 percent in control villages. Health surveillance data were obtained from 1437 households with children younger than 5 years in the intervention group (1919 children younger than 5 years), and from 1465 households (1916 children younger than 5 years) in the control group. 7-day prevalence of reported diarrhoea in children younger than 5 years was 8.8 percent in the intervention group and 9.1 percent in the control group (period prevalence ratio 0.97, 95 percent CI 0.83-1.12). 162 participants died in the intervention group (11 children younger than 5 years) and 151 died in the control group (13 children younger than 5 years).