02188nas a2200361   4500000000100000008004100001653001000042653002100052653002000073653001300093653001900106653002700125653001800152653001100170653001200181653001100193653002000204653001700224653001500241653001700256100001300273700002000286700001500306700001400321700001700335700001400352245013300366856006200499300001100561490000700572520123300579022001401812       2014                            d10aChild10aChild, Preschool10aCost of Illness10aDiarrhea10aDrinking water10aEnvironmental Exposure10aGlobal health10aHumans10aHygiene10aInfant10aResearch Design10aRisk Factors10aSanitation10aWater Supply1 aClasen T1 aPrüss-Ustün A1 aMathers CD1 aCumming O1 aCairncross S1 aColford J00aEstimating the impact of unsafe water, sanitation and hygiene on the global burden of disease: evolving and alternative methods.  uhttp://onlinelibrary.wiley.com/doi/10.1111/tmi.12330/epdf  a884-930 v193 a<p>The 2010 global burden of disease (GBD) study represents the latest effort to estimate the global burden of disease and injuries and the associated risk factors. Like previous GBD studies, this latest iteration reflects a continuing evolution in methods, scope and evidence base. Since the first GBD Study in 1990, the burden of diarrhoeal disease and the burden attributable to inadequate water and sanitation have fallen dramatically. While this is consistent with trends in communicable disease and child mortality, the change in attributable risk is also due to new interpretations of the epidemiological evidence from studies of interventions to improve water quality. To provide context for a series of companion papers proposing alternative assumptions and methods concerning the disease burden and risks from inadequate water, sanitation and hygiene, we summarise evolving methods over previous GBD studies. We also describe an alternative approach using population intervention modelling. We conclude by emphasising the important role of GBD studies and the need to ensure that policy on interventions such as water and sanitation be grounded on methods that are transparent, peer-reviewed and widely accepted.</p>
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