Evidence on the links between water insecurity, inadequate sanitation and mental health: A systematic review and meta-analysis.

Autor: Kimutai JJ; Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.; Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Lund C; Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.; Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa., Moturi WN; Department of Environmental Science, Faculty of Environment and Resource Development, Egerton University, Njoro, Kenya., Shewangizaw S; Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Feyasa M; Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Hanlon C; Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.; Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.; Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 May 25; Vol. 18 (5), pp. e0286146. Date of Electronic Publication: 2023 May 25 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0286146
Abstrakt: Background: Water insecurity and inadequate sanitation have adverse impacts on the mental health of individuals.
Objective: To review and synthesize evidence on the relationship between water insecurity, inadequate sanitation, and mental health globally.
Data Sources: Relevant studies were identified by searching PubMed, PsycINFO, and EMBASE databases from inception up to March 2023.
Study Eligibility Criteria: Only quantitative studies were included. The exposure was water insecurity and or inadequate sanitation. The outcome was common mental disorders (CMD: depression or anxiety), mental distress, mental health or well-being. There was no restriction on geographical location.
Participants: General population or people attending health facilities or other services.
Exposure: Water insecurity and/ or inadequate sanitation.
Risk of Bias: The effective Public Health Practice Project (EPHPP) assessment tool was used to assess quality of selected studies.
Synthesis of Results: A meta-analysis was conducted using a random effects statistical model.
Results: Twenty-five studies were included, with 23,103 participants from 16 countries in three continents: Africa (Kenya, Ethiopia, Ghana, Uganda, South Africa, Malawi, Mozambique, and Lesotho), Asia (Nepal, Bangladesh, India, and Iran) and the Americas (Brazil, Haiti, Bolivia and Vietnam). There was a statistically significant association between water insecurity and CMD symptoms. Nine studies reported a continuous outcome (5,248 participants): overall standardized mean difference (SMD = 1.38; 95% CI = 0.88, 1.87). Five studies reported a binary outcome (5,776 participants): odds ratio 5.03; 95% CI = 2.26, 11.18. There was a statistically significant association between inadequate sanitation and CMD symptoms (7415 participants), overall SMD = 5.36; 95% CI = 2.51, 8.20.
Limitations: Most of the included studies were cross-sectional which were unable to examine temporal relationships.
Conclusions: Water insecurity and inadequate sanitation contribute to poorer mental health globally.
Implications of Key Findings: Interventions to provide basic water, sanitation and psychosocial support, could substantially contribute to reducing the burden of CMD alongside other health and social benefits.
Trial Registration: PROSPERO registration number: CRD42022322528.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Kimutai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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