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

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 4,586 households (24,969 individuals) in intervention villages and 4,894 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% to 12% in control villages.

Health surveillance data were obtained from 1,437 households with children younger than five years in the intervention group (1,919 children younger than five years) and from 1,465 households (1,916 children younger than five years) in the control group.

Seven day prevalence of reported diarrhoea in children younger than five years was 8.8% in the intervention group and 9.1% in the control group (period prevalence ratio 0.97, 95% CI 0.83—1.12). 162 participants died in the intervention group (11 children younger than five years) and 151 died in the control group (13 children younger than five years).