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Hand Hygiene Knowledge and Hand Dirtiness Assessment to Inform Alcohol-Based Hand Rub Appropriateness in Community Settings in Uganda and Kenya
Christiana Hug
tjv6@cdc.gov
Christiana Hug
Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
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Evelyn Makena Mugambi
Evelyn Makena Mugambi
Washington State University, Nairobi, Kenya;
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Maureen Kesande
Maureen Kesande
Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda;
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Caroline Pratt
Caroline Pratt
Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
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Lorna Maru
Lorna Maru
Washington State University, Nairobi, Kenya;
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Raymond Odinoh
Raymond Odinoh
Washington State University, Nairobi, Kenya;
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Fred Tusabe
Fred Tusabe
Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda;
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Matthew J. Lozier
Matthew J. Lozier
Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
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Victoria Trinies
Victoria Trinies
Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
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Graeme Prentice-Mott
Graeme Prentice-Mott
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Alexandra Medley
Alexandra Medley
Division of Foodborne, Waterborne, and Environmental Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Alexandra Kossik
Alexandra Kossik
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Isaac Ngere
Isaac Ngere
Washington State University, Nairobi, Kenya;
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M. Kariuki Njenga
M. Kariuki Njenga
Washington State University, Nairobi, Kenya;
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Mohammed Lamorde
Mohammed Lamorde
Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda;
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David Berendes
David Berendes
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ABSTRACT.
During the coronavirus disease 2019 pandemic, alcohol-based hand rub (ABHR) availability and use increased as a prevention measure. ABHR is a convenient, effective way to kill microbes on hands but is hampered by the presence of organic material, whereas handwashing with water and soap (HWWS) can physically remove microbes and dirt. Although ABHR is preferred in most health care settings, the suitability of ABHR use in community settings has not been measured. We compared characteristics between community members and health care personnel (HCP) to inform considerations for promoting ABHR in community settings. We included data from community locations and health care facilities in Kenya and Uganda collected between 2021 and 2022. Hand dirtiness swabs were measured using the Quantitative Personal Hygiene Assessment Tool (qPHAT), a visual scale where 0 is very visibly dirty and 10 is no visible dirt. Participants were also asked about the appropriate method to use when hands were visibly dirty. Hand swabs were collected from HCP and community members. Both groups had median qPHAT scores of five. Neither the adjusted odds of having a qPHAT score less than or equal to five (1.4, 95% CI: 0.8–2.2) nor the adjusted odds of responding correctly to the knowledge question (0.8, 95% CI: 0.4–1.4) differed significantly by setting. People in community settings may, therefore, have comparable hand dirtiness and knowledge of appropriate hand hygiene practices to use ABHR as a HWWS complement. Further investigation into guidance and use of supportive messaging should be considered as completed elsewhere.
Author Notes
Financial support: Portions of this project were supported via an Interagency Agreement with the
Disclosures: The data collection protocol was reviewed by institutional review boards at the Kenya Medical Research Institute (Protocol No. SERU 4323), the Uganda Infectious Diseases Institute and Uganda National Council for Science and Technology, and at the CDC with a determination to be nonresearch (CDC Project ID 0900f3eb81e62919). The authors declare no competing financial interests. The findings and conclusions of this paper are those of the authors and do not necessarily represent the official position of the CDC.
Current contact information: Christiana Hug, Caroline Pratt, Matthew J. Lozier, Victoria Trinies, Graeme Prentice-Mott, Alexandra Medley, Alexandra Kossik, and David Berendes, Division of Foodborne, Waterborne and Environmental Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mails: tjv6@cdc.gov, cqpratt@gmail.com, wfu2@cdc.gov, omo3@cdc.gov, qbt1@cdc.gov, muv3@cdc.gov, spj0@cdc.gov, and uws8@cdc.gov. Evelyn Makena Mugambi, Lorna Maru, Raymond Odinoh, Isaac Ngere, and M. Kariuki Njenga, Washington State University, Nairobi, Kenya, E-mails: evelyn.mugambi@wsu.edu, lorna.maru@wsu.edu, raymond.odinoh@wsu.edu, isaac.ngere@wsu.edu, and mkariuki.njenga@wsu.edu. Maureen Kesande, Fred Tusabe, and Mohammed Lamorde, Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda, E-mails: mkesande@idi.co.ug, ftusabe@idi.co.ug, and mlamorde@idi.co.ug.
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-
20.
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-
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-
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Edmonds SL, Macinga DR, Mays-Suko P, Duley C, Rutter J, Jarvis WR, Arbogast JW, 2012. Comparative efficacy of commercially available alcohol-based hand rubs and World Health Organization-recommended hand rubs: Formulation matters. Am J Infect Control 40: 521–525.
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23.
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-
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