Table 2.
Characteristics of studies. Characteristics of included studies in the systematic review with the JMP WASH category, country, exposures, effect size (odds ratio or adjusted odds ratio), and diagnostic methods
| Study | Country | JMP WASH Category | Exposures |
Effect Size (Odds Ratio) |
Diagnostic Methods | Controlled Variable†† |
|---|---|---|---|---|---|---|
| Alba et al. 2016 [30] | Indonesia |
Water Treatment (Untreated water) |
Water treatment before drinking (Never) | 1.68 (0.99–2.82)† | Serology and culture | |
|
Sanitation (Open defecation) |
Places used to defecate (Field) | 0.98 (0.72–1.34) | ||||
|
Sanitation (Open defecation) |
Places used to defecate (Pond/river/canal) | 0.77 (0.56–1.06)† | ||||
| Hygiene (Limited) | Soap near toilet (Never) | 4.4 (2.0–9.65)† | ||||
| Aye et al. 2004 [31] | Myanmar |
Water Source (Surface water) |
Drink untreated river water | 12.5 (2.8–75.3)* | Diazo urine test or positive widal test | Drink untreated river water, Contact with typhoid patient, Hand washing with soap, Travel to other place |
| Hygiene (Basic) | Hand washing with soap | 0.15 (0.03–0.81)* | ||||
| Batool et al. 2022 [27] | Pakistan |
Water Treatment (Untreated water) |
Method of water purification used (None) | 0.93 (0.56–1.56)† | Blood culture | |
| Bhan et al. 2002 [32] | India |
Water Management (Unsafe water storage) |
Dirty container for storing drinking water | 1.99 (0.6–6.65)* | Blood culture | Ownership of dwelling, Nuclear family, No family member literate, Typhoid case in the family, Dirty container for storing drinking water, Nonuse of soap for washing hands, Water or drinks outside home, Lunch or dinner outside home, Consumption of ice cream |
| India | Hygiene (Limited) | Nonuse of soap for washing hands | 1.82 (1.04–3.21)*† | Blood culture | ||
| Bhunia et al. 2009 [8] | India | Water Source (Improved) | Drinking water (Piped water only) | 7.3 (2.5–21) | Widal test | |
| Water Source (Improved) | Drinking water (Tube well water) | 0.25 (0.08–0.75) | ||||
|
Water Treatment (Treated water) |
Drinking water (Purification) | 0.44 (0.19–1.0) | ||||
|
Water Management (Safe water storage) |
Drinking water (Covered container) | 0.25 (0.08–0.75) | ||||
|
Water Management (Safe water storage) |
Drinking water (Narrow mouth container) | 0.35 (0.15–0.76) | ||||
| Hygiene (Basic) | Soap hand wash before food | 1.9 (0.8–4.4) | ||||
| Hygiene (Basic) | Soap hand wash after defecation | 0.3 (0.12–0.75) | ||||
| Hygiene (Basic) | Soap hand wash after urination | 0.08 (0.03–0.26) | ||||
| Brainard et al. 2018 [22] | Democratic Republic of Congo | Hygiene (Not classified) | Wash hands after defecating (Always) | 2.71 (1.4–5.28)* | Diagnosis of clinical signs and Blood/bone marrow culture/duodenal fluid culture | Plate sharing, Occupation of head of household, Tap water is ever used, Wash hands after defecating, Water source chosen because it is protected, Visible urine/faeces at latrine |
| Bruh et al. 2017 [33] | Indonesia | Hygiene (Not classified) | Poor hand washing practice before eating | 4.295 (1.232–14.969) | TF Tubex | |
| Gauld et al. 2019 [23] | Malawi | Hygiene (Basic) | Soap available to wash hands after toilet use in the previous 3 wk | 0.6 (0.4-0.98)*† | Blood culture | Seeking care at QECH if child is severely ill, ≥ 1 household members admitted to hospital for febrile illness and cleaning with river water, > 1 drinking water source used, Child spends the day at school, preschool, nursery, or any other daycare, Cooking and cleaning using water from an open dug well, Family grows crops, Age, Distance from household to primary water source, No. of days water is stored, Experienced water shortage in the house or surrounding area, Soap available to wash hands after toilet use, Stores drinking water in drum, Used stream or river water for drinking |
| Giri et al. 2021 [28] | India |
Water Treatment (Treated water) |
Treatment of household water (boiling, filtration, reverse osmosis) | 0.45 (0.25–0.80)*† | Blood culture | Treatment of household water (boiling, filtration, reverse osmosis), Washed produce before eating, Consumption of street food by mother during past week |
| Kabwama et al. 2017 [34] | Uganda | Water Source (Not classified) | Consumed implicated drinks | 1.9 (0.68–5.10) | Diagnosis of clinical signs | |
| Karkey et al. 2013 [35] | Nepal |
Water Management (Safe water storage) |
Metal covering of water storage | 0.22 (0.1–0.6) | Blood culture | |
| Luby et al. 1998 [36] | Pakistan |
Water Treatment (Treated water) |
Home water (Clean home drinking water) | 0.9 (0.4–1.9)† | Blood culture | |
|
Water Treatment (Untreated water) |
Home water (Grossly contaminated) | 1.1 (0.6–2.1)† | ||||
| Luxemburger et al. 2001 [37] | Vietnam |
Water Source (Surface water) |
Drinking river water | 1.8 (0.8–5.6)† | Blood culture | |
|
Water Treatment (Untreated water) |
Drinking unboiled water | 1.5 (0.8–3.3)† | ||||
|
Sanitation (Open defecation) |
Defecation in a fish pond or river | 1.1 (0.5–3.2)† | ||||
| Mermin et al. 1999 [38] | Tajikistan |
Water Treatment (Treated water) |
Boiled water in home | 0.2 (0.05–0.6)*† | Blood and stool culture | Drinking unboiled water (or boiling water in the home), Obtaining water from an outside tap, Eating butter, Eating apples |
|
Water Treatment (Untreated water) |
Drinking unboiled water | 9.6 (3.0–34.0)*† | ||||
| Mirembe et al. 2019 [26] | Uganda |
Water Treatment (Treated water) |
Do you treat your drinking water? | 9.23 (4.84–17.61)* | Diagnosis of clinical signs | Level of formal education, water treatment for the drinking water, washing hands with soap |
| Hygiene (Basic) | Do you wash hands with soap? | 1.81 (0.95–3.45)* | ||||
| Muti et al. 2014 [39] | Zimbabwe |
Water Treatment (Treated water) |
Boil drinking water | 0.24 (0.07–0.90)* | Diagnosis of clinical signs | Water from well, Burst sewer pipe within 500 m of home, Typhoid contact at home, Store water in wide mouthed container with lid, Boil drinking water, Storage of water in a narrow mouthed container with lid |
|
Water Management (Safe water storage) |
Store water in wide mouthed container with lid | 3.68 (1.62–8.35)* | ||||
|
Water Management (Safe water storage) |
Storage of water in a narrow mouthed container with lid | 0.43 (0.22–0.8)* | ||||
| Nyamusore et al. 2018 [40] | Rwanda | Hygiene (Not classified) | Washing hands after using the latrine (Sometimes or never) | 1.78 (1.21–2.62)* | Diagnosis of clinical signs | Time spent in the camp, Level of completed education, Family members treated for typhoid fever in the past 3 months, Heard about typhoid fever before the outbreak, Washing hands after using the latrine, Most common source for food, Frequency of jerry-can washing |
| Prasad et al. 2018 [24] | Fiji | Water Source (Surface water) | Drank from an alternative water source (surface water source) | 3.61 (1.44–9.06)*† | Blood culture | Drank from an alternate water source (surface water source), Water not always available from main source, Did not wash produce before eating, Had any unimproved sewerage/damaged improved sewerage system, Undamaged, improved, municipal sewerage, Unimproved pit latrine, No toilet/Open defecation, Damaged improved, municipal sewerage, Improved pit latrine, Intact septic, High handwashing frequency after defecation, Use soap for handwashing |
| Water Source (Surface water) | Main household water source (Surface water source) | 1.28 (0.35–4.70) | ||||
|
Water Treatment (Treated water) |
Treated water in house | 0.89 (0.57–1.39)† | ||||
|
Water Treatment (Untreated water) |
Drank untreated water | 1.8 (1.07–3.03)† | ||||
| Sanitation (Unimproved) | Unimproved pit latrine | 49.47 (9.42–259.92)* | ||||
|
Sanitation (Open defecation) |
No toilet (Open defecation) | 9.87 (0.85–114.35)*† | ||||
| Hygiene (Basic) | Use soap for handwashing | 0.61 (0.37–0.95)*† | ||||
| Qamar et al. 2018 [25] | Pakistan | Water Source (Not classified) | Unsafe drinking water | 1.19 (0.8–1.78)* | Blood culture | Unsafe drinking water, Construction material of house, Number of people per toilet in household, Antibiotic use in 4 weeks before illness, History of contact with person with typhoid, Male sex, Eating outside of house |
| Ram et al. 2007 [41] | Bangladesh | Water Source (Improved) | Pipe to municipal supply | 0.5 (0.2–1.1)† | Blood culture | Unboiled water, Foul-smelling water, Use of latrine, Papaya |
|
Water Treatment (Treated water) |
Disinfected water at home using boiling or filtration | 0.7 (0.4–1.6)† | ||||
|
Water Treatment (Untreated water) |
Drinking unboiled water at home | 12.1 (2.2–65.6)*† | ||||
| Hygiene (Basic) | Soap observed in home | 0.5 (0.2–1.3)† | ||||
| Sharma et al. 2009 [42] | India | Water Source (Improved) | Drinking water (Piped water supply at home) | 0.4 (0.2–0.9) | Widal test | |
| Water Source (Surface water) | Drinking water (Stream water at home) | 1.6 (0.9–2.6) | ||||
|
Water Treatment (Treated water) |
Drinking water (Drinking boiled water) | 1.3 (0.6–2.6) | ||||
|
Water Management (Safe water storage) |
Storage of water (Narrow-mouthed container) | 0.4 (0.2–0.7) | ||||
|
Sanitation (Open defecation) |
Toilet facilities (Nearby stream) | 1.5 (0.9–2.7) | ||||
| Siddiqui et al. 2008 [43] | Pakistan | Hygiene (Limited) | Soap available near hand washing facility (No) | 2.6 (1.1–6.3)*† | Blood culture or serology test | Number of person in household, Soap available near hand washing facility, Use medicated soap, Aware of contact with known typhoid case |
| Hygiene (Not classified) | Wash hands after using toilet (Never) | 4 (1.6–10.2) | ||||
| Hygiene (Not classified) | Wash hands before meal regularly (No) | 1.6 (0.9–2.9) | ||||
| Srikantiah et al. 2007 [44] | Uzbekistan |
Water Source (Improved) |
Drinking water habits outside home (Piped water) | 0.6 (0.3–1.6)† | Blood culture | Drinking unboiled surface water outside home, Student as primary occupation, Antimicrobials in 2 weeks before illness onset, Routinely washing vegetables, Dining at a tea-house |
|
Water Source (Surface water) |
Surface water at home | 1.9 (0.7–4.9)† | ||||
|
Water Treatment (Treated water) |
Drinking water habits at home (Boiled water) | 0.4 (0.2–0.8)† | ||||
|
Water Treatment (Untreated water) |
Drinking water habits at home (Unboiled water) | 2.1 (1–4.4)† | ||||
|
Water Management (Safe water storage) |
Storing water (Keep water container covered) | 0.2 (0.04–1.1) | ||||
| Tran et al. 2005 [45] | Vietnam |
Water Treatment (Untreated water) |
Drinking untreated water | 3.9 (2.0–7.5)*† | Blood or stool culture | Uneducated people, Contact with a typhoid case, Drinking untreated water, Eating shellfish |
|
Sanitation (Open defecation) |
Sewage disposal directly to the environment | 2.4 (1–5.8)† | ||||
| Velema et al. 1997 [46] | Indonesia | Hygiene (Limited) | Does not use soap when washing hands | 29.8 (2.19–407.0)* | Diagnosis of clinical signs and Widal test | University education, Single, Warung, Soap, Wash clothes, Age, Sex |
| Vighio et al. 2021 [29] | Pakistan |
Water Treatment (Treated water) |
Boiling drinking water (Yes) | 0.3 (0.2–0.7)† | Culture | |
| Vollaard et al. 2004 [47] | Indonesia | Water Source (Improved) | Drinking water (Piped water) | 0.44 (0.19–1.01)† | Blood culture | No use of soap for handwashing, Sharing food from same plate, No toilet in household, Recent typhoid in household, Young age, Flooding, Use of iced drinks, Use of ice cubes, Crowding |
| Hygiene (Limited) | No use of soap for handwashing | 1.91 (1.06–3.46)*† |
* adjusted odds ratio from multivariate analysis
† estimates included in the meta-analysis
†† Controlled variables in the multivariate analysis