HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Luby, S. P. Articles by Hoekstra, R. M. PubMed PubMed Citation Articles by Luby, S. P. Articles by Hoekstra, R. M.

Difficulties in Maintaining Improved Handwashing Behavior, Karachi, Pakistan

In an earlier study in Karachi, Pakistan, households that received free soap and handwashing promotion for 9 months reported 53% less diarrhea than controls. Eighteen months after the intervention ended, these households were enrolled in a follow-up study to assess sustainability of handwashing behavior. Upon re-enrollment, mothers in households originally assigned to the intervention were 1.5 times more likely to have a place with soap and water to wash hands (79% versus 53%, P = 0.001) and when asked to wash hands were 2.2 times more likely to rub their hands together at least three times (50% versus 23%, P = 0.002) compared with controls. In the ensuing 14 months, former intervention households reported a similar proportion of person-days with diarrhea (1.59% versus 1.88%, P = 0.66) as controls. Although intervention households showed better handwashing technique after 2 years without intervention, their soap purchases and diarrhea experience was not significantly different from controls.

Received February 20, 2009. Accepted for publication April 15, 2009.

Acknowledgments: The authors thank the HOPE staff workers who worked in the community, Aqil Hussain, Gharnata Tabassum, Zahida Kanum, Badar Abdul Rehman and Sabeen Ismail who supervised the daily field work and data collection, and Faisal Sarwari and Asif Ahmed who supervised data entry.

Financial support: Funding for this study was provided by the Procter & Gamble Company and the Centers for Disease Control and Prevention. E.K.’s contribution to this manuscript was supported by National Institute of General Medical Sciences Grant F32GM085945.

^* Address correspondence to Stephen Luby, ICDDR,B: International Centre for Diarrheal Disease Research, Bangladesh, GPO Box 128, Dhaka-1000, Bangladesh. E-mail: sluby{at}icddrb.org

Authors’ addresses: Stephen P. Luby, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh, Tel: 88-02-988-1761, Fax: 88-02-882-3963, E-mail: sluby{at}icddrb.org. Mubina Agboatwalla, Health Oriented Preventive Education, 5 Amir Khusro Road, Block 7/8 Overseas Cooperative Housing Society, Karachi, Pakistan, Tel: 92-21-453-9393, E-mail: agboat{at}gerrys.net. Anna Bowen, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 33033, Tel: 404-639-4636, E-mail: aqb0{at}CDC.GOV. Eben Kenah, University of Washington University School of Public Health and Community Medicine, 1100 Fairview Ave. N., LE-400, PO Box 19024, Seattle, WA 98109-1024, Tel: 206-543-1144, Fax: 206-543-3813, E-mail: eek4{at}u.washington.edu. Yushuf Sharker, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh, Tel: 88-02-988-1761, Fax: 88-02-886-0523, E-mail: yushuf{at}icddrb.org. Robert M. Hoekstra, National Center for Zoonotic, Vector-Borne, and Enteric Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, Tel: 404-639-4712, E-mail: rth6{at}cdc.gov.

This article has been cited by other articles:

				Improved Handwashing Behavior Difficult to Sustain Journal Watch Infectious Diseases, July 15, 2009; 2009(715): 5 - 5. [Full Text]