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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Effects of Boiling Drinking Water on Diarrhea and Pathogen-Specific Infections in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
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Effects of Boiling Drinking Water on Diarrhea and Pathogen-Specific Infections in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

机译：沸腾饮用水对低收入国家腹泻和病原体特异性感染的影响：系统审查和荟萃分析

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摘要

Globally, approximately 2 billion people lack microbiologically safe drinking water. Boiling is the most prevalent household water treatment method, yet evidence of its health impact is limited. To conduct this systematic review, we searched four online databases with no limitations on language or publication date. Studies were eligible if health outcomes were measured for participants who reported consuming boiled and untreated water. We used reported and calculated odds ratios (ORs) and random-effects meta-analysis to estimate pathogen-specific and pooled effects by organism group and nonspecific diarrhea. Heterogeneity and publication bias were assessed using I-2, meta-regression, and funnel plots; study quality was also assessed. Of the 1,998 records identified, 27 met inclusion criteria and reported extractable data. We found evidence of a significant protective effect of boiling for Vibrio cholerae infections (OR = 0.31, 95% confidence interval [CI] = 0.13-0.79, N = 4 studies), Blastocystis (OR = 0.35, 95% CI = 0.17-0.69, N = 3), protozoal infections overall (pooled OR = 0.61, 95% CI = 0.43-0.86, N = 11), viral infections overall (pooled OR = 0.83, 95% CI = 0.7-0.98, N = 4), and nonspecific diarrheal outcomes (OR = 0.58, 95% CI = 0.45-0.77, N = 7). We found no evidence of a protective effect for helminthic infections. Although our study was limited by the use of self-reported boiling and non-experimental designs, the evidence suggests that boiling provides measureable health benefits for pathogens whose transmission routes are primarily water based. Consequently, we believe a randomized controlled trial of boiling adherence and health outcomes is needed.
机译：在全球范围内，大约20亿人缺乏微生物饮用水。沸腾是最普遍的家庭水处理方法，但其健康影响的证据是有限的。要进行这一系统审查，我们搜索了四个在线数据库，没有关于语言或出版日期的限制。如果针对报告消耗煮沸和未经处理的水的参与者测量了健康结果，则研究有资格。我们使用报告并计算了几种方法（或者）和随机效应的Meta分析，以估计生物体组和非特异性腹泻的病原体特异性和合并效应。使用I-2，Meta-Resollion和漏斗图评估异质性和出版物偏差;还评估了研究质量。在鉴定的1,998条记录中，27次符合纳入标准和报告可提取的数据。我们发现了沸腾的沸腾的显着保护作用，用于振动霍乱感染（或= 0.31,95％置信区间[CI] = 0.13-0.79，n = 4研究），囊胚（或= 0.35,95％CI = 0.17-0.69 ，N = 3），总体外流感染（汇集或= 0.61,95％CI = 0.43-0.86，n = 11），总体病毒感染（合并或= 0.83,95％CI = 0.7-0.98，n = 4），和非特异性腹泻结果（或= 0.58,95％CI = 0.45-0.77，n = 7）。我们发现没有证据证明蠕虫感染的保护作用。虽然我们的研究受到自我报告的沸腾和非实验设计的限制，但证据表明，沸腾为传输路线主要是水的病原体提供可测量的健康益处。因此，我们认为需要一种随机对照试验的沸腾依从性和健康结果。

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