Editing Diarrhea (section)

===Sanitation===
{{Further|WASH#Health aspects}}
Numerous studies have shown that improvements in drinking water and sanitation ([[WASH]]) lead to decreased risks of diarrhoea.<ref name=":0">{{cite journal | vauthors = Wolf J, Prüss-Ustün A, Cumming O, Bartram J, Bonjour S, Cairncross S, Clasen T, Colford JM, Curtis V, De France J, Fewtrell L, Freeman MC, Gordon B, Hunter PR, Jeandron A, Johnston RB, Mäusezahl D, Mathers C, Neira M, Higgins JP | title = Assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: systematic review and meta-regression | journal = Tropical Medicine & International Health | volume = 19 | issue = 8 | pages = 928–42 | date = August 2014 | pmid = 24811732 | doi = 10.1111/tmi.12331 | s2cid = 22903164 | url = https://ueaeprints.uea.ac.uk/51912/1/Wolf_2014_Assessing_impact_of_drinking_water.pdf | doi-access = free | access-date = 17 December 2019 | archive-date = 13 April 2020 | archive-url = https://web.archive.org/web/20200413184758/https://ueaeprints.uea.ac.uk/id/eprint/51912/1/Wolf_2014_Assessing_impact_of_drinking_water.pdf | url-status = live }}</ref> Such improvements might include for example use of water filters, provision of high-quality [[drinking water|piped water]] and [[sanitary sewer|sewer]] connections.<ref name=":0" />

In institutions, communities, and households, interventions that promote [[hand washing]] with soap lead to significant reductions in the incidence of diarrhea.<ref name=":1">{{cite journal | vauthors = Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA | title = Hand-washing promotion for preventing diarrhoea | journal = The Cochrane Database of Systematic Reviews | volume = 12 | pages = CD004265 | date = January 2021 | issue = 1 | pmid = 33539552 | pmc = 8094449 | doi = 10.1002/14651858.CD004265.pub4 }}</ref> The same applies to preventing [[open defecation]] at a community-wide level and providing access to [[improved sanitation]].<ref name="UN2015">{{cite web|title=Call to action on sanitation|url=http://sanitationdrive2015.org/wp-content/uploads/2013/03/DSG_Sanitation_Fast-Facts_final.pdf|website=United Nations|access-date=15 August 2014|url-status=usurped|archive-url=https://web.archive.org/web/20140819084624/http://sanitationdrive2015.org/wp-content/uploads/2013/03/DSG_Sanitation_Fast-Facts_final.pdf|archive-date=19 August 2014}}</ref><ref>{{cite journal | vauthors = Spears D, Ghosh A, Cumming O | title = Open defecation and childhood stunting in India: an ecological analysis of new data from 112 districts | journal = PLOS ONE | volume = 8 | issue = 9 | pages = e73784 | year = 2013 | pmid = 24066070 | pmc = 3774764 | doi = 10.1371/journal.pone.0073784 | doi-access = free | bibcode = 2013PLoSO...873784S }}</ref> This includes use of [[toilet]]s and implementation of the entire [[sanitation]] chain connected to the toilets (collection, transport, disposal or reuse of [[human waste|human excreta]]).

There is limited evidence that safe disposal of child or adult feces can prevent diarrheal disease.<ref>{{cite journal | vauthors = Majorin F, Torondel B, Ka Seen Chan G, Clasen T | title = Interventions to improve disposal of child faeces for preventing diarrhoea and soil-transmitted helminth infection | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | pages = CD011055 | date = September 2019 | issue = 9 | pmid = 31549742 | pmc = 6757260 | doi = 10.1002/14651858.CD011055.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref><ref>{{cite journal | vauthors = Clasen TF, Bostoen K, Schmidt WP, Boisson S, Fung IC, Jenkins MW, Scott B, Sugden S, Cairncross S | title = Interventions to improve disposal of human excreta for preventing diarrhoea | journal = The Cochrane Database of Systematic Reviews | issue = 6 | pages = CD007180 | date = June 2010 | volume = 2010 | pmid = 20556776 | pmc = 6532559 | doi = 10.1002/14651858.CD007180.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref>

====Hand washing====
Basic sanitation techniques can have a profound effect on the transmission of diarrheal disease. The implementation of hand washing using soap and water, for example, has been experimentally shown to reduce the incidence of disease by approximately 30–48%.<ref>{{cite journal | vauthors = Curtis V, Cairncross S | title = Effect of washing hands with soap on diarrhoea risk in the community: a systematic review | journal = The Lancet. Infectious Diseases | volume = 3 | issue = 5 | pages = 275–81 | date = May 2003 | pmid = 12726975 | doi = 10.1016/S1473-3099(03)00606-6 }}</ref><ref>{{cite journal | vauthors = Cairncross S, Hunt C, Boisson S, Bostoen K, Curtis V, Fung IC, Schmidt WP | title = Water, sanitation and hygiene for the prevention of diarrhoea | journal = International Journal of Epidemiology | volume = 39 | issue = Suppl 1 | pages = i193-205 | date = April 2010 | pmid = 20348121 | pmc = 2845874 | doi = 10.1093/ije/dyq035 }}</ref><ref name=":1" /> Hand washing in developing countries, however, is compromised by poverty as acknowledged by the [[Centers for Disease Control and Prevention|CDC]]: "Handwashing is integral to disease prevention in all parts of the world; however, access to soap and water is limited in a number of less developed countries. This lack of access is one of many challenges to proper hygiene in less developed countries." Solutions to this barrier require the implementation of educational programs that encourage sanitary behaviours.<ref>{{cite web|title=Diarrheal Diseases in Less Developed Countries|url=https://www.cdc.gov/healthywater/hygiene/ldc/diarrheal_diseases.html|work=CDC|access-date=28 October 2013|url-status=live|archive-url=https://web.archive.org/web/20131104042634/http://www.cdc.gov/healthywater/hygiene/ldc/diarrheal_diseases.html|archive-date=4 November 2013}}</ref>

====Water====
Given that water contamination is a major means of transmitting diarrheal disease, efforts to provide clean [[water supply]] and [[improved sanitation]] have the potential to dramatically cut the rate of disease incidence. In fact, it has been proposed that we might expect an 88% reduction in child mortality resulting from diarrheal disease as a result of improved water sanitation and hygiene.<ref name="Brown 629–34"/><ref>{{cite journal | vauthors = Black RE, Morris SS, Bryce J | s2cid = 14509705 | title = Where and why are 10 million children dying every year? | journal = Lancet | volume = 361 | issue = 9376 | pages = 2226–34 | date = June 2003 | pmid = 12842379 | doi = 10.1016/S0140-6736(03)13779-8 }}</ref> Similarly, a meta-analysis of numerous studies on improving water supply and sanitation shows a 22–27% reduction in disease incidence, and a 21–30% reduction in mortality rate associated with diarrheal disease.<ref>{{cite journal | vauthors = Esrey SA, Feachem RG, Hughes JM | title = Interventions for the control of diarrhoeal diseases among young children: improving water supplies and excreta disposal facilities | journal = Bulletin of the World Health Organization | volume = 63 | issue = 4 | pages = 757–72 | year = 1985 | pmid = 3878742 | pmc = 2536385 }}</ref>

Chlorine treatment of water, for example, has been shown to reduce both the risk of diarrheal disease, and of contamination of stored water with diarrheal pathogens.<ref>{{cite journal | vauthors = Arnold BF, Colford JM | title = Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis | journal = The American Journal of Tropical Medicine and Hygiene | volume = 76 | issue = 2 | pages = 354–64 | date = February 2007 | pmid = 17297049 | doi = 10.4269/ajtmh.2007.76.354 | doi-access = free }}</ref>