{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:50:33Z","timestamp":1787161833677,"version":"build-2736575974"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"publisher","award":["025386"],"award-info":[{"award-number":["025386"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Global cholera control efforts rely heavily on effective water, sanitation, and hygiene (WASH) interventions in cholera-endemic settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from a large, randomized controlled trial of oral cholera vaccine conducted in Kolkata, India, we evaluated whether natural variations in WASH in an urban slum setting were predictive of cholera risk. From the control population (n = 55 086), baseline WASH data from a randomly selected \u201ctraining subpopulation\u201d (n = 27 634) were analyzed with recursive partitioning to develop a dichotomous (\u201cbetter\u201d vs \u201cnot better\u201d) composite household WASH variable from several WASH features collected at baseline, and this composite variable was then evaluated in a mutually exclusive \u201cvalidation population\u201d (n = 27 452). We then evaluated whether residents of better WASH households in the entire population (n = 55 086) experienced lower cholera risk using Cox regression models. Better WASH was defined by a combination of 4 dichotomized WASH characteristics including safe source of water for daily use, safe source of drinking water, private or shared flush toilet use, and always handwashing with soap after defecation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Residence in better WASH households was associated with a 30% reduction in risk of cholera over a 5-year period (adjusted hazard ratio, 0.70 [95% confidence interval, .49\u2013.99]; P = .048). We also found that the impact of better WASH households on reducing cholera risk was greatest in young children (0\u20134 years) and this effect progressively declined with age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The evidence suggests that modest improvements in WASH facilities and behaviors significantly modify cholera risk and may be an important component of cholera prevention and elimination strategies in endemic settings.<\/jats:p>\n                    <jats:p>Clinical Trials Registration. NCT00289224.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofad535","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T08:33:42Z","timestamp":1698222822000},"source":"Crossref","is-referenced-by-count":8,"title":["Better Existing Water, Sanitation, and Hygiene Can Reduce the Risk of Cholera in an Endemic Setting: Results From a Prospective Cohort Study From Kolkata, India"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1584-484X","authenticated-orcid":false,"given":"Md Taufiqul","family":"Islam","sequence":"first","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3762-084X","authenticated-orcid":false,"given":"Justin","family":"Im","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Ahmmed","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deok Ryun","family":"Kim","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birkneh Tilahun","family":"Tadesse","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Kang","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4158-5995","authenticated-orcid":false,"given":"Farhana","family":"Khanam","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahima","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasnuva","family":"Ahmed","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Golam","family":"Firoj","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0203-5744","authenticated-orcid":false,"given":"Asma Binte","family":"Aziz","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masuma","family":"Hoque","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juyeon","family":"Park","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyon Jin","family":"Jeon","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"},{"name":"Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus , Cambridge , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman","family":"Kanungo","sequence":"additional","affiliation":[{"name":"National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research , Kolkata, West Bengal , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanta","family":"Dutta","sequence":"additional","affiliation":[{"name":"National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research , Kolkata, West Bengal , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalequ","family":"Zaman","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraful Islam","family":"Khan","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6043-7170","authenticated-orcid":false,"given":"Florian","family":"Marks","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"},{"name":"Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus , Cambridge , United Kingdom"},{"name":"Madagascar Institute for Vaccine Research, University of Antananarivo , Antananarivo , Madagascar"},{"name":"Heidelberg Institute of Global Health, University of Heidelberg , Heidelberg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome H","family":"Kim","sequence":"additional","affiliation":[{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdausi","family":"Qadri","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D","family":"Clemens","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh"},{"name":"International Vaccine Institute Epidemiology, Public Health, Impact Unit, , Seoul , Republic of Korea"},{"name":"Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles , Los Angeles, California , 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