This study is the first to adapt U.S. EPA Method 533 to detect PFAS (Per- and Polyfluoroalkyl Substances) in beer, examining how contamination in municipal drinking water affects PFAS levels in beers brewed across different U.S. states and internationally. Analyzing 23 beers—mostly lagers and ales—from various brewery sizes and locations, the research found that PFAS, particularly PFOS, PFOA, and PFBS, were frequently detected in beers, especially those brewed in areas with known PFAS contamination in tap water. The study demonstrates a strong correlation between PFAS in brewing water and PFAS levels in beer, with smaller breweries located near contaminated water sources showing higher PFAS concentrations. It also emphasizes that conventional water treatment at breweries may not remove PFAS, highlighting the need for improved filtration practices. By revealing that 18% of U.S. breweries operate in areas with PFAS-contaminated municipal water, the study provides essential data for brewers, consumers, and policymakers to make informed decisions about PFAS exposure and risk in beverages.

This study develops and applies a mechanistic transmission model to explore why WASH (Water, Sanitation, and Hygiene) interventions often produce inconsistent results across different settings. By simulating intervention trials, the researchers examined how four key factors—community coverage, compliance, intervention efficacy, and the proportion of transmission that can be blocked—interact with contextual variables such as baseline disease prevalence and existing WASH infrastructure. Two hypothetical scenarios were modeled: one with low and one with high baseline disease prevalence. In the low-prevalence scenario, even moderate levels of coverage and compliance led to substantial health improvements. In contrast, the high-prevalence scenario required much higher levels of coverage and compliance to achieve similar reductions in disease burden. The findings highlight that WASH intervention outcomes are non-linear and highly dependent on context and interactions between factors. Many of the null results observed in recent WASH trials may not reflect failed interventions, but rather mismatches between the intervention design and local conditions. The study demonstrates that mechanistic models can play a critical role in enhancing policy development and intervention planning by allowing program designers to simulate realistic, location-specific scenarios. This work responds to growing calls in the WASH research community for better tools to generalize trial results and inform more targeted, evidence-based decision-making.

The authors analyzed data from three rigorously conducted trials, WASH Benefits Bangladesh, WASH Benefits Kenya, and the SHINE trial in Zimbabwe, to evaluate the impact of household-level Water, Sanitation, and Hygiene (WASH) interventions, as well as Infant and Young Child Feeding (IYCF) programs, on child health outcomes. The WASH interventions included measures such as drinking water chlorination, improved latrine construction, and the provision of handwashing stations. Despite high levels of compliance, WASH interventions alone did not lead to improvements in child linear growth in any of the three countries. In contrast, IYCF interventions consistently resulted in modest but positive increases in children's length-for-age Z scores, ranging from approximately 0.13 to 0.25 across all trials. Combining WASH and IYCF interventions offered no additional growth benefits beyond those achieved by IYCF alone. With respect to diarrhoea, reductions were observed only in Bangladesh, where the intervention included frequent promotional visits (six times per month). In Kenya and Zimbabwe, where promotional visits occurred only monthly, no reductions in diarrhoea were observed. These findings suggest that observed associations between household sanitation and child stunting in observational studies may be confounded by underlying socioeconomic factors, and that randomized trial results do not support a causal relationship. Overall, the results indicate that household-level WASH interventions, as currently designed and implemented, are likely insufficient to improve child growth outcomes. Achieving meaningful health impacts may require more transformative or community-scale approaches that can significantly reduce exposure to fecal contamination and enteric pathogens.

This study is an analysis from the SHINE trial, a community-based, cluster-randomized, 2×2 factorial trial conducted in rural Zimbabwe. The trial evaluated the effects of two interventions: a Water, Sanitation, and Hygiene (WASH) package and an Infant and Young Child Feeding (IYCF) program. The WASH intervention included the provision of improved pit latrines, handwashing stations with liquid soap, point-of-use water chlorination, and the creation of clean child play spaces. The IYCF intervention focused on enhancing infant feeding practices to improve child health and development. The main outcomes measured were the molecularly detected prevalence and quantity of 29 different enteric pathogens in children's stool samples, collected at several timepoints throughout infancy and during diarrheal episodes. The study found that the WASH intervention led to only a small reduction in the burden of parasitic infections, with no measurable impact on bacterial or viral pathogen levels. Similarly, the IYCF intervention did not reduce the burden of enteric infections. Moreover, neither intervention resulted in a decrease in the incidence of pathogen-attributable diarrhea. These findings suggest that the standard household-level WASH improvements implemented in the SHINE trial were not sufficient to interrupt fecal–oral transmission in a highly contaminated rural environment. The results highlight the need for more transformative and comprehensive WASH solutions that can more effectively reduce exposure to enteric pathogens in such settings.

In this systematic review and meta-analysis, we showed that WASH interventions reduced risk of diarrhoea. Drinking water interventions, specifically drinking water of higher quality and water filtered at POU, reduced risk of diarrhoea up to around 50%. Basic sanitation services without sewer connection resulted in a 21% reduction in diarrhoea risk and basic sanitation services with sewer connection resulted in a 47% reduction, compared with unimproved or limited sanitation. Combining water or sanitation interventions with other WASH interventions did not substantially increase reduction in diarrhoea. Handwashing promotion with or without broader hygiene education reduced diarrhoea by 30%. Only five (4%) of 124 included studies reported results by sex, showing the extent to which reporting of sex-disaggregated data is specifically limited in this context.

India is home to one-third of the global population without access to improved sanitation, with widespread open defecation and high rates of diarrhoeal mortality. To address this issue, a cluster-randomized controlled trial was conducted in 100 villages in Odisha, where intervention villages received latrine construction alongside behavior-change promotion efforts, while control villages received no intervention. The primary outcome measured was the prevalence of diarrhea in children. Despite an increase in latrine coverage in intervention areas, the study found no significant reductions in child diarrhoea, soil-transmitted helminth infections, or indicators of malnutrition. These results suggest that simply providing sanitation infrastructure is not sufficient to improve health outcomes. Effective sanitation programs must also achieve high levels of uptake, consistent latrine use, and meaningful reductions in environmental exposure to fecal contamination.

The study developed a mechanistic susceptible–infectious–susceptible (SIS) transmission model calibrated using Bayesian sampling and maximum-likelihood techniques to fit data from the WASH Benefits Bangladesh randomized trial of over 17,000 observations. The investigators simulated counterfactual scenarios that varied contextual and intervention parameters such as preexisting WASH conditions, baseline disease burden, intervention compliance, efficacy, coverage, and the proportion of transmission pathways left unmodified. Results indicated that increasing community-level intervention coverage from approximately 5% (typical in trials) to 20% led to dramatic gains in effectiveness—median improvements of around 34 percentage points for WSH and 45 percentage points when nutrition was added. The effectiveness of interventions was significantly reduced in contexts with poorer baseline WASH infrastructure or higher initial disease prevalence. Combined interventions provided complementary benefits, though not synergistic interactions. The authors conclude that individual-level WASH strategies, even when implemented with high fidelity, are unlikely to deliver meaningful health improvements unless community coverage reaches levels sufficient to disrupt pathogen transmission—akin to herd protection.

NaDCC tablets are a widely used form of chlorine for disinfecting drinking water at the household level. When dissolved in water, they form hypochlorous acid, which effectively inactivates bacteria and viruses (>99%) but is less effective against protozoa and helminths (<80%). The tablets are most effective in clear water with pH between 5.5–7.5 and require a minimum of 30 minutes for disinfection. Though easy to use and lightweight, NaDCC tablets require proper storage and adherence to dosage instructions. They are globally available, with brands like Aquatabs being common, and offer a viable solution for improving water safety in areas with limited water treatment infrastructure.

In the first webinar of the "WASH Cycle" series, Gloria Magut presented research on bottled drinking water sold in Embakasi Central, Nairobi, Kenya. Her study tested 158 samples from eight different brands for physical (e.g., pH), chemical (e.g., fluoride, lead), and microbial contaminants (e.g., E. coli, HPC). Key findings included: 1. 12% of the samples contained E. coli, despite national standards requiring 0% presence. 2. 13% exceeded the fluoride concentration limit of 1.5 mg/L, with one brand reaching 3.53 mg/L. 3. Most chemical parameters fell within acceptable limits, but deviations in pH suggested inconsistencies in treatment processes. The presentation also discussed gaps in regulation, poor storage practices (e.g., exposure to sunlight), and the potential for counterfeit refills of branded bottles, which further undermine water safety. Gloria recommended enhanced monitoring, public disclosure of water test results, better training for water treatment personnel, and improved public awareness of water safety risks. The Q&A addressed community involvement, fluoride health impacts, microplastic concerns, regulatory authorities (like KEBS), and the importance of boiling vs. testing water.