Is targeting access to sanitation enough?

Exposure to faecal pathogens including rotavirus, pathogenic strains of Escherichia coli, Vibrio cholerae, Shigella spp, Salmonella enterica serotype Typhi, hepatitis E virus, and soil-transmitted helminths can precipitate serious human illness. However, systematic reviews of efforts to reduce exposure to human faeces through improvement of sanitation have shown that the evidence of a health benefit is based on weak study designs that restrict scientific inference and do not provide conclusive evidence that approaches being implemented to improve sanitation in low-income communities actually improve health.