1921
Volume 82, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Effective handwashing with soap requires reliable access to water supplies. However, more than three billion persons do not have household-level access to piped water. This research addresses the challenge of improving hand hygiene within water-constrained environments. The antimicrobial efficacy of alcohol-based hand sanitizer, a waterless hand hygiene product, was evaluated and compared with handwashing with soap and water in field conditions in Dar es Salaam, Tanzania. Hand sanitizer use by mothers resulted in 0.66 and 0.64 log reductions per hand of and fecal streptococci, respectively. In comparison, handwashing with soap resulted in 0.50 and 0.25 log reductions per hand of and fecal streptococci, respectively. Hand sanitizer was significantly better than handwashing with respect to reduction in levels of fecal streptococci ( = 0.01). The feasibility and health impacts of promoting hand sanitizer as an alternative hand hygiene option for water-constrained environments should be assessed.

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2017-11-25
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References

  1. Boschi-Pinto C, Velebit L, Shibuya K, , 2008. Estimating child mortality due to diarrhoea in developing countries. Bull World Health Organ 86: 710717.[Crossref]
  2. Black RE, Morris SS, Bryce J, , 2003. Where and why are 10 million children dying every year? Lancet 361: 22262234.[Crossref]
  3. Curtis V, Cairncross S, , 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3: 275281.[Crossref]
  4. Curtis V, Biran A, Deverell K, Hughes C, Bellamy K, Drasar B, , 2003. Hygiene in the home: relating bugs and behaviour. Soc Sci Med 57: 657672.[Crossref]
  5. Curtis V, Cairncross S, Yonli R, , 2000. Review: domestic hygiene and diarrhoea- pinpointing the problem. Trop Med Int Health 5: 2232.[Crossref]
  6. Trevett AF, Carter RC, Tyrrel SF, , 2004. Water quality deterioration: a study of household drinking water quality in rural Honduras. Int J Environ Health Res 14: 273283.[Crossref]
  7. Curtis V, , 2003 Talking dirty: how to save a million lives. Int J Environ Health Res 13 (Suppl 1): S73S79.[Crossref]
  8. Larsen, 2003. Hygiene and health in developing countries: defining priorities through cost-benefit assessments. Int J Environ Health Res 13: 3746.[Crossref]
  9. Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, , 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 4252.[Crossref]
  10. Esrey SA, Feachem RG, Hughes JM, , 1985. Interventions for the control of diarrhoeal diseases among young children: improving water supplies and excreta disposal facilities. Bull World Health Organ 63: 757772.
  11. Ejemot R, Ehiri J, Meremikwu M, Critchley J, , 2008. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev 23: CD004265.
  12. Aiello AE, Coulborn RM, Perez V, Larson EL, , 2008. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health 98: 13721381.[Crossref]
  13. Curtis VA, Danquah LO, Aunger RV, , 2009. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res 24: 655673.[Crossref]
  14. Curtis V, Kanki B, Mertens T, Traore E, Diallo I, Tall F, Cousens S, , 1995. Potties, pits and pipes: Explaining hygiene behaviour in Burkina Faso. Soc Sci Med 41: 383393.[Crossref]
  15. Gilman RH, Marquis GS, Ventura G, Campos M, Spira W, Diaz F, , 1993. Water cost and availability: key determinants of family hygiene in a Peruvian shantytown. Am J Public Health 83: 15541558.[Crossref]
  16. Oswald WE, Hunter GC, Lescano AG, Cabrera L, Leontsini E, Pan WK, Soldan VP, Gilman RH, , 2008. Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water. Trop Med Int Health 13: 1421.[Crossref]
  17. Tumwine JK, Katui-Katua M, Munguti KK, , 2002. Drawers of Water. II: 30 Years of Change in Domestic Use and Environmental Health in East Africa. London: International Institute for Environment and Development.
  18. Kampf G, Kramer A, , 2004. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 17: 863893.[Crossref]
  19. Boyce JM, Pittet D, , 2002. Guideline for hand hygiene in health-care settings. Recommendations of the healthcare infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 51: 145.
  20. Pittet D, , 2001. Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerg Infect Dis 7: 234240.[Crossref]
  21. World Health Organization, 2006. WHO Guidelines on Hand Hygiene in Health Care (Advanced Draft). Geneva: World Health Organization, World Alliance for Patient Safety.
  22. Bloomfield SF, Aiello AE, Cookson B, O’Boyle C, Larson EL, , 2007. The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers. Am J Infect Control 35: S27S64.[Crossref]
  23. Traub-Dargatz JL, Weese JS, Rousseau JD, Dunowska M, Morley PS, Dargatz DA, , 2006. Pilot study to evaluate 3 hygiene protocols on the reduction of bacterial load on the hands of veterinary staff performing routine equine physical examinations. Can Vet J 47: 671676.
  24. Davis MA, Sheng H, Newman J, Hancock DD, Hovde CJ, , 2006. Comparison of a waterless hand-hygiene preparation and soap-and-water hand washing to reduce coliforms on hands in animal exhibit settings. Epidemiol Infect 134: 10241028.[Crossref]
  25. Hoque BA, , 2003. Handwashing practices and challenges in Bangladesh. Int J Environ Health Res 13 (Suppl 1): S81S87.[Crossref]
  26. Kaltenthaler E, Waterman R, Cross P, , 1991. Faecal indicator bacteria on the hands and the effectiveness of hand-washing in Zimbabwe. Trop Med Int Health 94: 358363.
  27. Sobel J, Mahon B, Mendoza CE, Passaro D, Cano F, Baier K, Racioppi F, Hutwagner L, Mintz E, , 1998. Reduction of fecal contamination of street-vended beverages in Guatemala by a simple system for water purification and storage, handwashing, and beverage storage. Am J Trop Med Hyg 59: 380387.
  28. Luby SP, Agboatwalla M, Raza A, Sobel J, Mintz ED, Baier K, Hoekstra RM, Rahbar MH, Hassan R, Qureshi SM, , 2001. Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan. Epidemiol Infect 127: 237244.[Crossref]
  29. Kaltenthaler EC, Drasar BS, , 1996. The study of hygiene behaviour in Botswana: a combination of qualitative and quantitative methods. Trop Med Int Health 1: 690698.[Crossref]
  30. Pinfold JV, Horan NJ, , 1996. Measuring the effect of a hygiene behaviour intervention by indicators of behaviour and diarrhoeal disease. Trans R Soc Trop Med Hyg 90: 366371.[Crossref]
  31. Pinfold JV, , 1990. Faecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water supply and sanitation activities on faeco-oral disease transmission. I. A case study in rural north-east Thailand. Epidemiol Infect 105: 363375.[Crossref]
  32. Larson EL, Gomez-Duarte C, Lee LV, Della-Latta P, Kain DJ, Keswick BH, , 2003. Microbial flora of hands of homemakers. Am J Infect Control 31: 7279.[Crossref]
  33. Larson EL, Strom MS, Evans CA, , 1980. Analysis of three variables in sampling solutions used to assay bacteria of hands: type of solution, use of antiseptic neutralizers, and solution temperature. J Clin Microbiol 12: 355360.
  34. Trick WE, Vernon MO, Hayes RA, Nathan C, Rice TW, Peterson BJ, Segreti J, Welbel SF, Solomon SL, Weinstein RA, , 2003. Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital. Clin Infect Dis 36: 13831390.[Crossref]
  35. Kaltenthaler EC, Pinfold JV, , 1995. Microbiological methods for assessing handwashing practice in hygiene behaviour studies. J Trop Med Hyg 98: 101106.
  36. Luby SP, Agboatwalla M, Billhimer W, Hoekstra RM, , 2007. Field trial of a low cost method to evaluate hand cleanliness. Trop Med Int Health 12: 765771.[Crossref]
  37. USEPA, 2002. Method 1604: Total Coliforms and Escherichia coli in Water by Membrane Filtration Using a Simultaneous Detection Technique (MI Medium). Washington, DC: United States Environmental Protection Agency
  38. Clesceri LS, Greenberg AE, Eaton AD, , 1998. Standard Methods for the Examination of Water and Wastewater. Washington, DC: American Public Health Association.
  39. Clasen TF, Brown J, Collin S, Suntura O, Cairncross S, , 2004. Reducing diarrhea through the use of household-based ceramic water filters: a randomized, controlled trial in rural Bolivia. Am J Trop Med Hyg 70: 651657.
  40. Levy K, Nelson KL, Hubbard A, Eisenberg JN, , 2008. Following the water: a controlled study of drinking water storage in northern coastal Ecuador. Environ Health Perspect 116: 15331540.[Crossref]
  41. Horak HM, Chynoweth JS, Myers WP, Davis JA, Fendorf S, Boehm AB, , 2009. Microbial and metal water quality in rain catchments compared with traditional drinking water sources in the East Sepik Province, Papua New Guinea. J Water Health (in press). doi:10.2166/wh.2009.233
  42. Rainey RC, Harding AK, , 2005. Drinking water quality and solar disinfection: effectiveness in peri-urban households in Nepal. J Water Health 3: 239248.[Crossref]
  43. Clasen TF, Bastable A, , 2003. Faecal contamination of drinking water during collection and household storage: the need to extend protection to the point of use. J Water Health 1: 109116.
  44. Laborde DL, Weigle KA, Weber DJ, Kotch JB, , 1993. Effect of fecal contamination on diarrheal illness rates in day-care centers. Am J Epidemiol 138: 243255.[Crossref]
  45. Kac G, Podglajen I, Gueneret M, Vaupré S, Bissery A, Meyer G, , 2005. Microbiological evaluation of two hand hygiene procedures achieved by healthcare workers during routine patient care: a randomized study. J Hosp Infect 60: 3239.[Crossref]
  46. Hoque BA, Mahalanabis D, Alam MJ, Islam MS, , 1995. Post-defecation handwashing in Bangladesh: practice and efficiency perspectives. Public Health 109: 1524.[Crossref]
  47. Manun’Ebo M, Cousens S, Haggerty P, Kalengaie M, Ashworth A, Kirkwood B, , 1997. Measuring hygiene practices: a comparison of questionnaires with direct observations in rural Zaire. Trop Med Int Health 2: 10151021.[Crossref]
  48. Sickbert-Bennett EE, Weber DJ, Gergen-Teague MF, Rutala WA, , 2004. The effects of test variables on the efficacy of hand hygiene agents. Am J Infect Control 32: 6983.[Crossref]
  49. Todar K, , 2002. The Bacterial Flora of Humans. Madison, WI: Department of Bacteriology, University of Wisconsin.
  50. Hardina CM, Fujioka RS, , 1991. Soil: the environmental source of Escherichia coli and enterococci in Hawaii's streams. Environ Toxicol Water Qual 6: 185195.[Crossref]
  51. Fierer N, Hamady M, Lauber CL, Knight R, , 2008. The influence of sex, handedness, and washing on the diversity of hand surface bacteria. Proc Natl Acad Sci USA 105: 1799417999.[Crossref]
  52. Centers for Disease Control and Prevention, 2002. Guidelines for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Atlanta: Centers for Disease Control and Prevention.
  53. Ahmed QA, Memish ZA, Allegranzi B, Pittet D, , 2006. Muslim health-care workers and alcohol-based handrubs. Lancet 367: 10251027.[Crossref]
  54. Luby SP, Agboatwalla M, Bowen A, Kenah E, Sharker Y, Hoekstra RM, , 2009. Difficulties in maintaining improved handwashing behavior, Karachi, Pakistan. Am J Trop Med Hyg 81: 140145.[Crossref]
  55. Hammond B, Ali Y, Fendler E, Dolan M, Donovan S, , 2000. Effect of hand sanitizer use on elementary school absenteeism. Am J Infect Control 28: 340346.[Crossref]
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  • Received : 28 Apr 2009
  • Accepted : 27 Oct 2009

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