{"id":"https://openalex.org/W7204697282","doi":"https://doi.org/10.61919/bmkmb705","title":"Assessing the Impact of Community-Led Sanitation Programs on Diarrheal Disease Incidence in Rural Punjab","display_name":"Assessing the Impact of Community-Led Sanitation Programs on Diarrheal Disease Incidence in Rural Punjab","publication_year":2026,"publication_date":"2026-02-28","ids":{"openalex":"https://openalex.org/W7204697282","doi":"https://doi.org/10.61919/bmkmb705"},"language":"en","primary_location":{"id":"doi:10.61919/bmkmb705","doi":"https://doi.org/10.61919/bmkmb705","is_oa":true,"landing_page_url":"https://doi.org/10.61919/bmkmb705","pdf_url":null,"source":{"id":"https://openalex.org/S5407043305","display_name":"Journal of Health Wellness and Community Research","issn_l":"3007-0570","issn":["3007-0570"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health, Wellness and Community Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.61919/bmkmb705","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5099764476","display_name":"Bilal Safdar","orcid":"https://orcid.org/0009-0009-1316-3371","observed_orcids":["https://orcid.org/0009-0009-1316-3371"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Bilal Safdar","raw_affiliation_strings":["CMH Lahore Medical College, Lahore, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"CMH Lahore Medical College, Lahore, Pakistan","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104141137","display_name":"Muhammad Talha Aziz","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I169077156","display_name":"St. Francis College","ror":"https://ror.org/00571jt67","country_code":"US","type":"education","lineage":["https://openalex.org/I169077156"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Muhammad Talha Aziz","raw_affiliation_strings":["Doctor of Veterinary Medicine, Master of Public Health, St. Francis College, Brooklyn, New York, United States of America"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Doctor of Veterinary Medicine, Master of Public Health, St. Francis College, Brooklyn, New York, United States of America","institution_ids":["https://openalex.org/I169077156"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148625390","display_name":"Syed Faraz Munir Bukhari","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I36448004","display_name":"Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology","ror":"https://ror.org/05yfc2w21","country_code":"PK","type":"education","lineage":["https://openalex.org/I36448004"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Syed Faraz Munir Bukhari","raw_affiliation_strings":["MBBS, MSPH, Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"MBBS, MSPH, Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan","institution_ids":["https://openalex.org/I36448004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003717188","display_name":"Talha Rehman","orcid":"https://orcid.org/0000-0002-4833-6529","observed_orcids":["https://orcid.org/0000-0002-4833-6529"]},"institutions":[{"id":"https://openalex.org/I191365509","display_name":"Hamdard University","ror":"https://ror.org/01zrv0z61","country_code":"PK","type":"education","lineage":["https://openalex.org/I191365509"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Talha Rehman","raw_affiliation_strings":["MBBS student, Hamdard College of Medicine, Karachi, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"MBBS student, Hamdard College of Medicine, Karachi, Pakistan","institution_ids":["https://openalex.org/I191365509"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147234230","display_name":"Ahmad Riaz","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I127670440","display_name":"Bahauddin Zakariya University","ror":"https://ror.org/05x817c41","country_code":"PK","type":"education","lineage":["https://openalex.org/I127670440"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Ahmad Riaz","raw_affiliation_strings":["MPhil, Bahauddin Zakariya University and Punjab Food Authority, Multan, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"MPhil, Bahauddin Zakariya University and Punjab Food Authority, Multan, Pakistan","institution_ids":["https://openalex.org/I127670440"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5123286394","display_name":"Aneela Tahir","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I195024194","display_name":"Riphah International University","ror":"https://ror.org/02kdm5630","country_code":"PK","type":"education","lineage":["https://openalex.org/I195024194"]}],"countries":["PK"],"is_corresponding":false,"raw_author_name":"Aneela Tahir","raw_affiliation_strings":["Lecturer, Riphah International University, Islamabad, Pakistan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lecturer, Riphah International University, Islamabad, Pakistan","institution_ids":["https://openalex.org/I195024194"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":5,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":"1","last_page":"11"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10596","display_name":"Child Nutrition and Water Access","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10596","display_name":"Child Nutrition and Water Access","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10976","display_name":"Viral gastroenteritis research and epidemiology","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10209","display_name":"Global Maternal and Child Health","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/childhood-diarrhea","display_name":"childhood diarrhea","score":0.9800000190734863},{"id":"https://openalex.org/keywords/rural-punjab","display_name":"rural Punjab","score":0.5849999785423279},{"id":"https://openalex.org/keywords/wash","display_name":"water, sanitation and hygiene","score":0.7239999771118164},{"id":"https://openalex.org/keywords/recurrent-diarrhea","display_name":"recurrent diarrhea","score":0.8960000276565552},{"id":"https://openalex.org/keywords/hospitalization","display_name":"hospitalization","score":0.7870000004768372},{"id":"https://openalex.org/keywords/intravenous-fluid-requirement","display_name":"intravenous fluid requirement","score":0.7870000004768372},{"id":"https://openalex.org/keywords/health-care-utilization","display_name":"health care utilization","score":0.7689999938011169},{"id":"https://openalex.org/keywords/children-under-five","display_name":"children under five","score":0.6579999923706055}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.803600013256073},{"id":"https://openalex.org/C2779802037","wikidata":"https://www.wikidata.org/wiki/Q40878","display_name":"Diarrhea","level":2,"score":0.7924000024795532},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.7534000277519226},{"id":"https://openalex.org/C3020710733","wikidata":"https://www.wikidata.org/wiki/Q40878","display_name":"Diarrheal disease","level":3,"score":0.7405999898910522},{"id":"https://openalex.org/C547646559","wikidata":"https://www.wikidata.org/wiki/Q162297","display_name":"Hygiene","level":2,"score":0.7365000247955322},{"id":"https://openalex.org/C2911096278","wikidata":"https://www.wikidata.org/wiki/Q40878","display_name":"Diarrheal diseases","level":3,"score":0.6976000070571899},{"id":"https://openalex.org/C2780151969","wikidata":"https://www.wikidata.org/wiki/Q949149","display_name":"Sanitation","level":2,"score":0.6901999711990356},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.6787999868392944},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.5616999864578247},{"id":"https://openalex.org/C2778750513","wikidata":"https://www.wikidata.org/wiki/Q1142751","display_name":"Norovirus","level":3,"score":0.47749999165534973},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.4332999885082245},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.39480000734329224},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.39160001277923584},{"id":"https://openalex.org/C2776283161","wikidata":"https://www.wikidata.org/wiki/Q174876","display_name":"Breastfeeding","level":2,"score":0.3855000138282776},{"id":"https://openalex.org/C129047720","wikidata":"https://www.wikidata.org/wiki/Q175185","display_name":"Rural area","level":2,"score":0.3659000098705292},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3424000144004822},{"id":"https://openalex.org/C2781081971","wikidata":"https://www.wikidata.org/wiki/Q7883042","display_name":"Under-five","level":2,"score":0.33730000257492065},{"id":"https://openalex.org/C2777919664","wikidata":"https://www.wikidata.org/wiki/Q552461","display_name":"Hand washing","level":3,"score":0.3303999900817871},{"id":"https://openalex.org/C2777910687","wikidata":"https://www.wikidata.org/wiki/Q6007834","display_name":"Improved sanitation","level":3,"score":0.32269999384880066},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.3028999865055084},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.30230000615119934},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.2838999927043915},{"id":"https://openalex.org/C986699","wikidata":"https://www.wikidata.org/wiki/Q7939","display_name":"El Ni\u00f1o","level":2,"score":0.27869999408721924},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.27300000190734863},{"id":"https://openalex.org/C61716771","wikidata":"https://www.wikidata.org/wiki/Q496","display_name":"Feces","level":2,"score":0.27239999175071716},{"id":"https://openalex.org/C2777895361","wikidata":"https://www.wikidata.org/wiki/Q1758614","display_name":"Longitudinal study","level":2,"score":0.265500009059906},{"id":"https://openalex.org/C2780664029","wikidata":"https://www.wikidata.org/wiki/Q5282120","display_name":"Disease burden","level":3,"score":0.26010000705718994}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.61919/bmkmb705","doi":"https://doi.org/10.61919/bmkmb705","is_oa":true,"landing_page_url":"https://doi.org/10.61919/bmkmb705","pdf_url":null,"source":{"id":"https://openalex.org/S5407043305","display_name":"Journal of Health Wellness and Community Research","issn_l":"3007-0570","issn":["3007-0570"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health, Wellness and Community Research","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.61919/bmkmb705","doi":"https://doi.org/10.61919/bmkmb705","is_oa":true,"landing_page_url":"https://doi.org/10.61919/bmkmb705","pdf_url":null,"source":{"id":"https://openalex.org/S5407043305","display_name":"Journal of Health Wellness and Community Research","issn_l":"3007-0570","issn":["3007-0570"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Health, Wellness and Community Research","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0},{"id":"https://metadata.un.org/sdg/6","display_name":"Clean water and sanitation","score":0.6618000268936157}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7047628422","https://openalex.org/W1512017885","https://openalex.org/W7134807813","https://openalex.org/W4225632657","https://openalex.org/W3168540390","https://openalex.org/W7236349","https://openalex.org/W2113284882","https://openalex.org/W2107875507","https://openalex.org/W4226163892","https://openalex.org/W2162028799"],"abstract_inverted_index":{"Background:":[0],"Childhood":[1],"diarrhea":[2,133],"remains":[3],"associated":[4,166],"with":[5,36,167],"inadequate":[6],"sanitation,":[7,66],"unsafe":[8],"feces":[9],"disposal,":[10],"and":[11,22,37,57,67,72,75,88,106,116,154,172,180],"poor":[12],"hygiene":[13,68],"in":[14,33,54,59,103,108,135,143,150,157],"rural":[15,34],"Pakistan.":[16],"Objective:":[17],"To":[18],"compare":[19],"diarrheal":[20,73,99,170],"incidence":[21,112,171],"related":[23],"clinical":[24],"outcomes":[25,77],"among":[26],"children":[27],"younger":[28],"than":[29],"five":[30],"years":[31],"living":[32],"communities":[35,56,105],"without":[38],"active":[39],"community-led":[40],"sanitation":[41],"programming.":[42],"Methods:":[43],"A":[44],"longitudinal":[45],"community-based":[46],"cohort":[47],"study":[48],"enrolled":[49],"620":[50],"households,":[51],"including":[52],"312":[53],"sanitation-program":[55,104,163],"308":[58],"comparison":[60,109],"communities.":[61,110],"Baseline":[62],"child,":[63],"household,":[64],"water,":[65],"characteristics":[69],"were":[70,78,92,101,114],"recorded,":[71],"episodes":[74,100,118],"healthcare":[76,175],"assessed":[79],"during":[80],"follow-up.":[81],"Incidence":[82],"was":[83,165],"expressed":[84],"per":[85,119],"100":[86,120],"child-months,":[87,121],"crude":[89,127],"group":[90],"comparisons":[91],"calculated":[93],"from":[94],"reported":[95],"data.":[96],"Results:":[97],"Seventy-nine":[98],"recorded":[102,169],"141":[107],"Reported":[111],"rates":[113],"2.1":[115],"3.8":[117],"respectively,":[122],"corresponding":[123],"to":[124],"an":[125],"approximate":[126],"incidence-rate":[128],"ratio":[129],"of":[130,139],"0.55.":[131],"Recurrent":[132],"occurred":[134],"5.4%":[136],"versus":[137,145,152,159],"12.7%":[138],"children,":[140],"hospital":[141,155],"visits":[142],"7.1%":[144],"13.3%,":[146],"intravenous":[147],"fluid":[148],"requirements":[149],"3.5%":[151],"7.8%,":[153],"admissions":[156],"2.6%":[158],"5.5%.":[160],"Conclusion:":[161],"Community":[162],"exposure":[164],"lower":[168],"reduced":[173],"diarrhea-related":[174],"utilization.":[176],"The":[177],"observational":[178],"design":[179],"incomplete":[181],"adjusted":[182],"analysis":[183],"precluded":[184],"causal":[185],"inference":[186]},"counts_by_year":[],"updated_date":"2026-10-28T10:33:24.094632","created_date":"2026-08-31T00:00:00"}