{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:05:31Z","timestamp":1790975131222,"version":"4.1.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1171432"],"award-info":[{"award-number":["OPP1171432"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sustained investments in water, sanitation, and hygiene (WASH) have lagged in resource-poor settings; incremental WASH improvements may, nonetheless, prevent diseases such as typhoid in disease-endemic populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using prospective data from a large cohort in urban Kolkata, India, we evaluated whether baseline WASH variables predicted typhoid risk in a training subpopulation (n\u2005=\u200528\u202f470). We applied a machine learning algorithm to the training subset to create a composite, dichotomous (good, not good) WASH variable based on 4 variables, and evaluated sensitivity and specificity of this variable in a validation subset (n\u2005=\u200528\u202f470). We evaluated in Cox regression models whether residents of \u201cgood\u201d WASH households experienced a lower typhoid risk after controlling for potential confounders. We constructed virtual clusters (radius 50 m) surrounding each household to evaluate whether a prevalence of good WASH practices modified the typhoid risk in central household members.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Good WASH practices were associated with protection in analyses of all households (hazard ratio [HR]\u2005=\u20050.57; 95% confidence interval [CI], .37\u2013.90; P\u2005=\u2005.015). This protection was evident in persons \u22655 years old at baseline (HR\u2005=\u20050.47; 95% CI, .34\u2013.93; P\u2005=\u2005.005) and was suggestive, though not statistically significant, in younger age groups (HR\u2005=\u20050.61; 95% CI, .27\u20131.38; P\u2005=\u2005.235). The level of surrounding household good WASH coverage was also associated with protection (HR\u2005=\u20050.988; 95% CI, .979\u2013.996; P\u2005=\u2005.004, for each percent coverage increase). However, collinearity between household WASH and WASH coverage prevented an assessment of their independent predictive contributions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this typhoid-endemic setting, natural variation in household WASH was associated with typhoid risk. If replicated elsewhere, these findings suggest that WASH improvements may enhance typhoid control, short of major infrastructural investments.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1429","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T19:23:47Z","timestamp":1600370627000},"page":"e720-e726","source":"Crossref","is-referenced-by-count":26,"title":["Can Existing Improvements of Water, Sanitation, and Hygiene (WASH) in Urban Slums Reduce the Burden of Typhoid Fever in These Settings?"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3762-084X","authenticated-orcid":false,"given":"Justin","family":"Im","sequence":"first","affiliation":[{"name":"International Vaccine Institute, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Taufiqul","family":"Islam","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Ahmmed","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deok Ryun","family":"Kim","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraful","family":"Islam Khan","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalequ","family":"Zaman","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Ali","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Marks","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Seoul, Republic of Korea"},{"name":"Department of Medicine, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdausi","family":"Qadri","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Kim","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D","family":"Clemens","sequence":"additional","affiliation":[{"name":"International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh"},{"name":"University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"key":"2021060106112500800_CIT0001","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1093\/cid\/ciy1116","article-title":"Salmonella Typhi from blood cultures in the Democratic Republic of the Congo: a 10-year surveillance","volume":"68","author":"Tack","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2021060106112500800_CIT0002","doi-asserted-by":"crossref","first-page":"e570","DOI":"10.1016\/S2214-109X(14)70301-8","article-title":"Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment","volume":"2","author":"Mogasale","year":"2014","journal-title":"Lancet Global Health"},{"key":"2021060106112500800_CIT0003","doi-asserted-by":"crossref","first-page":"e0005376","DOI":"10.1371\/journal.pntd.0005376","article-title":"The burden of typhoid fever in low- and middle-income countries: a meta-regression approach","volume":"11","author":"Antill\u00f3n","year":"2017","journal-title":"PLOS Negl Trop Dis"},{"key":"2021060106112500800_CIT0004","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S1473-3099(18)30685-6","article-title":"The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017","volume":"19","author":"Global Burden of Disease (GBD) 2017 Typhoid and Paratyphoid Collaborators","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2021060106112500800_CIT0005","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1056\/NEJMoa0807521","article-title":"A cluster-randomized effectiveness trial of Vi typhoid vaccine in India","volume":"361","author":"Sur","year":"2009","journal-title":"N Engl J Med"},{"key":"2021060106112500800_CIT0006","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1037\/a0016973","article-title":"An introduction to recursive partitioning: rationale, application, and characteristics of classification and regression trees, bagging, and random forests","volume":"14","author":"Strobl","year":"2009","journal-title":"Psychol Methods"},{"key":"2021060106112500800_CIT0007","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s10994-009-5119-5","article-title":"Measuring classifier performance: a coherent alternative to the area under the ROC curve","volume":"77","author":"Hand","year":"2009","journal-title":"Machine Learn"},{"key":"2021060106112500800_CIT0008","doi-asserted-by":"crossref","first-page":"3093","DOI":"10.1002\/sim.1228","article-title":"Estimation of the area under the ROC curve","volume":"21","author":"Faraggi","year":"2002","journal-title":"Stat Med"},{"key":"2021060106112500800_CIT0009","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/1471-2105-12-77","article-title":"pROC: an open-source package for R and S+ to analyze and compare ROC curves","volume":"12","author":"Robin","year":"2011","journal-title":"BMC Bioinformatics"},{"key":"2021060106112500800_CIT0010","volume-title":"Modeling survival data: extending the Cox model","author":"Terry","year":"2000"},{"key":"2021060106112500800_CIT0011","volume-title":"Lionel Henry and Kirill M\u00fcller dplyr: a grammar of data manipulation. R package version 0.7.6","author":"Hadley Wickham","year":"2018"},{"key":"2021060106112500800_CIT0012","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/inthealth\/ihz069","article-title":"Re-evaluating herd protection by Vi typhoid vaccine in a cluster randomized trial","volume":"12","author":"Ali","year":"2020","journal-title":"Int Health"},{"key":"2021060106112500800_CIT0013","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1093\/ije\/dyz060","article-title":"Unmasking herd protection by an oral cholera vaccine in a cluster-randomized trial","volume":"48","author":"Ali","year":"2019","journal-title":"Int J Epidemiol"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaa1429\/34058042\/ciaa1429.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/72\/11\/e720\/38389387\/ciaa1429.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/72\/11\/e720\/38389387\/ciaa1429.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T07:53:28Z","timestamp":1622534008000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/72\/11\/e720\/5910137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,22]]},"references-count":13,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,9,22]]},"published-print":{"date-parts":[[2021,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaa1429","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6,1]]},"published":{"date-parts":[[2020,9,22]]}}}