Author:
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-
1.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE, 2012. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 379: 2151–2161.
-
2.
Moonie S, Sterling DA, Figgs LW, Castro M, 2008. The relationship between school absence, academic performance, and asthma status. J Sch Health 78: 140–148.
-
3.
Dyer DL, Shinder A, Shinder F, 2000. Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism. Fam Med 32: 633–638.
-
4.
Haller L, Hutton G, Bertram J, 2007. Estimating the costs and health benefits of water and sanitation improvements at global level. J Water Health 5: 467–480.
-
5.
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: 1372–1381.
-
6.
Jasper C, Le T-T, Bartram J, 2012. Water and sanitation in schools: a systematic review of the health and educational outcomes. Int J Environ Res Public Health 9: 2772–2787.
-
7.
Freeman MC, Greene LE, Dreibelbis R, Saboori S, Muga R, Brumback B, Rheingans R, 2012. Assessing the impact of a school-based water treatment, hygiene and sanitation programme on pupil absence in Nyanza Province, Kenya: a cluster-randomized trial. Trop Med Int Health 17: 380–391.
-
8.
Rosen L, Manor O, Engelhard D, Brody D, Rosen B, Peleg H, Meir M, Zucker D, 2006. Can a handwashing intervention make a difference? Results from a randomized controlled trial in Jerusalem preschools. Prev Med 42: 27–32.
-
9.
Talaat M, Afifi S, Dueger E, El-Ashry N, Marfin A, Kandeel A, Mohareb E, El-Sayed N, 2011. Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerg Infect Dis 17: 619–625.
-
10.
UNICEF, 2010. Water, Sanitation and Hygiene Annual Report 2010. New York, NY: UNICEF.
-
11.
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 (Suppl 1): S27–S64.
-
12.
Meadows E, Le Saux N, 2004. A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children. BMC Public Health 4: 50.
-
13.
Allegranzi B, Pittet D, 2007. Healthcare associated infection in developing countries: simple solutions to meet complex challenges. Infect Control Hosp Epidemiol 28: 1323–1327.
-
14.
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: 340–346.
-
15.
Sandora TJ, Shih MC, Goldmann DA, 2008. Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention. Pediatrics 121: e1555–e1562.
-
16.
Lau CH, Springston EE, Sohn MW, Mason I, Gadola E, Damitz M, Gupta RS, 2012. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study. BMC Pediatr 12: 52.
-
17.
Guinan M, McGuckin M, Ali Y, 2002. The effect of a comprehensive handwashing program on absenteeism in elementary schools. Am J Infect Control 30: 217–220.
-
18.
Sandora TJ, Taveras EM, Shih M-C, Resnick EA, Lee GM, Ross-Degnan D, Goldmann DA, Randomized A, 2005. Controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home. Pediatrics 116: 587–594.
-
19.
Lee GM, Salomon JA, Friedman JF, Hibberd PL, Ross-Degnan D, Zasloff E, Bediako S, Goldmann DA, 2005. Illness transmission in the home: a possible role for alcohol-based hand gels. Pediatrics 115: 852–860.
-
20.
Oughton MT, Loo VG, Dendukuri N, Fenn S, Libman MD, 2009. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile. Infect Control Hosp Epidemiol 30: 939–944.
-
21.
Liu P, Yuen Y, Hsiao H-M, Jaykus L-A, Moe C, 2010. Effectiveness of liquid soap and hand sanitizer against Norwalk virus on contaminated hands. Appl Environ Microbiol 76: 394–399.
-
22.
WHO, 2009. WHO Guidelines on Hand Hygiene in Health Care. Geneva: World Health Organization.
-
23.
Pickering AJ, Boehm AB, Mwanjali M, Davis J, 2010. Efficacy of waterless hand hygiene compared with handwashing with soap: a field study in Dar es Salaam, Tanzania. Am J Trop Med Hyg 82: 270–278.
-
24.
Pickering AJ, Davis J, Boehm AB, 2011. Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil. J Water Health 9: 429.
-
25.
Correa JC, Pinto D, Salas LA, Camacho JC, Rondon M, Quintero J, 2012. A cluster-randomized controlled trial of handrubs for prevention of infectious diseases among children in Colombia. Rev Panam Salud Publica 31: 476–484.
-
26.
Luby SP, Kadir MA, Yushuf Sharker MA, Yeasmin F, Unicomb L, Sirajul Islam M, 2011. A community-randomised controlled trial promoting waterless hand sanitizer and handwashing with soap, Dhaka, Bangladesh. Trop Med Int Health 15: 1508–1516.
-
27.
Breiman RF, Olack B, Shultz A, Roder S, Kimani K, Feikin DR, Burke H, 2011. Healthcare-use for major infectious disease syndromes in an informal settlement in Nairobi, Kenya. J Health Popul Nutr 29: 123.
-
28.
Feikin DR, Olack B, Bigogo GM, Audi A, Cosmas L, Aura B, Burke H, Njenga MK, Williamson J, Breiman RF, 2011. The burden of common infectious disease syndromes at the clinic and household level from population-based surveillance in rural and urban Kenya. PLoS One 6: e16085.
-
29.
Breiman RF, Cosmas L, Njuguna H, Audi A, Olack B, Ochieng JB, Wamola N, Bigogo GM, Awiti G, Tabu CW, 2012. Population-based incidence of typhoid fever in an urban informal settlement and a rural area in Kenya: implications for typhoid vaccine use in Africa. PLoS One 7: e29119.
-
30.
Gidudu J, Sack DA, Pina M, Hudson MJ, Kohl KS, Bishop P, Chatterjee A, Chiappini E, Compingbutra A, da Costa C, Fernandopulle R, Fischer TK, Haber P, Masana W, de Menezes MR, Kang G, Khuri-Bulos N, Killion LA, Nair C, Poerschke G, Rath B, Salazar-Lindo E, Setse R, Wenger P, Wong VC, Zaman K; Brighton Collaboration Diarrhea Working Group, 2011. Diarrhea: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 29: 1052–1071.
-
31.
Lewis S, Heaton K, 1997. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32: 920–924.
-
32.
Curtis VA, Danquah LO, Aunger RV, 2009. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res 24: 655–673.
-
33.
Wolf-Peter S, Robert A, Yolande C, Peninnah Mukiri M, Carol Nkatha M, Adam B, Val C, 2009. Determinants of handwashing practices in Kenya: the role of media exposure, poverty and infrastructure. Trop Med Int Health 14: 1534–1541.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 332 | 332 | 43 |
| Full Text Views | 3188 | 910 | 6 |
| PDF Downloads | 624 | 81 | 5 |
Access to Waterless Hand Sanitizer Improves Student Hand Hygiene Behavior in Primary Schools in Nairobi, Kenya
Amy J. Pickering
Amy J. Pickering
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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Jennifer Davis
Jennifer Davis
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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Annalise G. Blum
Annalise G. Blum
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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Jenna Scalmanini
Jenna Scalmanini
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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Beryl Oyier
Beryl Oyier
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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George Okoth
George Okoth
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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Robert F. Breiman
Robert F. Breiman
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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Pavani K. Ram
Pavani K. Ram
Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, California; Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya; University at Buffalo, State University of New York, Buffalo, New York
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Handwashing is difficult in settings with limited resources and water access. In primary schools within urban Kibera, Kenya, we investigated the impact of providing waterless hand sanitizer on student hand hygiene behavior. Two schools received a waterless hand sanitizer intervention, two schools received a handwashing with soap intervention, and two schools received no intervention. Hand cleaning behavior after toilet use was monitored for 2 months using structured observation. Hand cleaning after toileting was 82% at sanitizer schools (N = 2,507 toileting events), 38% at soap schools (N = 3,429), and 37% at control schools (N = 2,797). Students at sanitizer schools were 23% less likely to have observed rhinorrhea than control students (P = 0.02); reductions in student-reported gastrointestinal and respiratory illness symptoms were not statistically significant. Providing waterless hand sanitizer markedly increased student hand cleaning after toilet use, whereas the soap intervention did not. Waterless hand sanitizer may be a promising option to improve student hand cleansing behavior, particularly in schools with limited water access.
Author Notes
Financial support: This study was funded by Centers for Disease Control and Prevention—Kenya, Kenya Medical Research Institute, and the Freeman Spogli Institute for International Studies at Stanford University; GOJO Industries provided the alcohol-based hand sanitizer distributed to schools in this study.
Authors' addresses: Amy J. Pickering, Jennifer Davis, Annalise G. Blum, and Jenna Scalmanini, Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, CA, E-mails: amyjanel@stanford.edu, jennadavis@stanford.edu, annaliseblum@gmail.com, and jenscal6@gmail.com. Beryl Oyier, George Okoth, and Robert F. Breiman, Kenya Medical Research Institute, Centers for Disease Control and Prevention—Kenya, Nairobi, Kenya, E-mails: adhiamboyier@gmail.com, gokoth@ke.cdc.gov, and rfbreiman@emory.edu. Pavani K. Ram, University at Buffalo, State University of New York, Buffalo, NY, E-mail: pkram@buffalo.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE, 2012. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 379: 2151–2161.
-
2.
Moonie S, Sterling DA, Figgs LW, Castro M, 2008. The relationship between school absence, academic performance, and asthma status. J Sch Health 78: 140–148.
-
3.
Dyer DL, Shinder A, Shinder F, 2000. Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism. Fam Med 32: 633–638.
-
4.
Haller L, Hutton G, Bertram J, 2007. Estimating the costs and health benefits of water and sanitation improvements at global level. J Water Health 5: 467–480.
-
5.
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: 1372–1381.
-
6.
Jasper C, Le T-T, Bartram J, 2012. Water and sanitation in schools: a systematic review of the health and educational outcomes. Int J Environ Res Public Health 9: 2772–2787.
-
7.
Freeman MC, Greene LE, Dreibelbis R, Saboori S, Muga R, Brumback B, Rheingans R, 2012. Assessing the impact of a school-based water treatment, hygiene and sanitation programme on pupil absence in Nyanza Province, Kenya: a cluster-randomized trial. Trop Med Int Health 17: 380–391.
-
8.
Rosen L, Manor O, Engelhard D, Brody D, Rosen B, Peleg H, Meir M, Zucker D, 2006. Can a handwashing intervention make a difference? Results from a randomized controlled trial in Jerusalem preschools. Prev Med 42: 27–32.
-
9.
Talaat M, Afifi S, Dueger E, El-Ashry N, Marfin A, Kandeel A, Mohareb E, El-Sayed N, 2011. Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerg Infect Dis 17: 619–625.
-
10.
UNICEF, 2010. Water, Sanitation and Hygiene Annual Report 2010. New York, NY: UNICEF.
-
11.
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 (Suppl 1): S27–S64.
-
12.
Meadows E, Le Saux N, 2004. A systematic review of the effectiveness of antimicrobial rinse-free hand sanitizers for prevention of illness-related absenteeism in elementary school children. BMC Public Health 4: 50.
-
13.
Allegranzi B, Pittet D, 2007. Healthcare associated infection in developing countries: simple solutions to meet complex challenges. Infect Control Hosp Epidemiol 28: 1323–1327.
-
14.
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: 340–346.
-
15.
Sandora TJ, Shih MC, Goldmann DA, 2008. Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention. Pediatrics 121: e1555–e1562.
-
16.
Lau CH, Springston EE, Sohn MW, Mason I, Gadola E, Damitz M, Gupta RS, 2012. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study. BMC Pediatr 12: 52.
-
17.
Guinan M, McGuckin M, Ali Y, 2002. The effect of a comprehensive handwashing program on absenteeism in elementary schools. Am J Infect Control 30: 217–220.
-
18.
Sandora TJ, Taveras EM, Shih M-C, Resnick EA, Lee GM, Ross-Degnan D, Goldmann DA, Randomized A, 2005. Controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home. Pediatrics 116: 587–594.
-
19.
Lee GM, Salomon JA, Friedman JF, Hibberd PL, Ross-Degnan D, Zasloff E, Bediako S, Goldmann DA, 2005. Illness transmission in the home: a possible role for alcohol-based hand gels. Pediatrics 115: 852–860.
-
20.
Oughton MT, Loo VG, Dendukuri N, Fenn S, Libman MD, 2009. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile. Infect Control Hosp Epidemiol 30: 939–944.
-
21.
Liu P, Yuen Y, Hsiao H-M, Jaykus L-A, Moe C, 2010. Effectiveness of liquid soap and hand sanitizer against Norwalk virus on contaminated hands. Appl Environ Microbiol 76: 394–399.
-
22.
WHO, 2009. WHO Guidelines on Hand Hygiene in Health Care. Geneva: World Health Organization.
-
23.
Pickering AJ, Boehm AB, Mwanjali M, Davis J, 2010. Efficacy of waterless hand hygiene compared with handwashing with soap: a field study in Dar es Salaam, Tanzania. Am J Trop Med Hyg 82: 270–278.
-
24.
Pickering AJ, Davis J, Boehm AB, 2011. Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil. J Water Health 9: 429.
-
25.
Correa JC, Pinto D, Salas LA, Camacho JC, Rondon M, Quintero J, 2012. A cluster-randomized controlled trial of handrubs for prevention of infectious diseases among children in Colombia. Rev Panam Salud Publica 31: 476–484.
-
26.
Luby SP, Kadir MA, Yushuf Sharker MA, Yeasmin F, Unicomb L, Sirajul Islam M, 2011. A community-randomised controlled trial promoting waterless hand sanitizer and handwashing with soap, Dhaka, Bangladesh. Trop Med Int Health 15: 1508–1516.
-
27.
Breiman RF, Olack B, Shultz A, Roder S, Kimani K, Feikin DR, Burke H, 2011. Healthcare-use for major infectious disease syndromes in an informal settlement in Nairobi, Kenya. J Health Popul Nutr 29: 123.
-
28.
Feikin DR, Olack B, Bigogo GM, Audi A, Cosmas L, Aura B, Burke H, Njenga MK, Williamson J, Breiman RF, 2011. The burden of common infectious disease syndromes at the clinic and household level from population-based surveillance in rural and urban Kenya. PLoS One 6: e16085.
-
29.
Breiman RF, Cosmas L, Njuguna H, Audi A, Olack B, Ochieng JB, Wamola N, Bigogo GM, Awiti G, Tabu CW, 2012. Population-based incidence of typhoid fever in an urban informal settlement and a rural area in Kenya: implications for typhoid vaccine use in Africa. PLoS One 7: e29119.
-
30.
Gidudu J, Sack DA, Pina M, Hudson MJ, Kohl KS, Bishop P, Chatterjee A, Chiappini E, Compingbutra A, da Costa C, Fernandopulle R, Fischer TK, Haber P, Masana W, de Menezes MR, Kang G, Khuri-Bulos N, Killion LA, Nair C, Poerschke G, Rath B, Salazar-Lindo E, Setse R, Wenger P, Wong VC, Zaman K; Brighton Collaboration Diarrhea Working Group, 2011. Diarrhea: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 29: 1052–1071.
-
31.
Lewis S, Heaton K, 1997. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32: 920–924.
-
32.
Curtis VA, Danquah LO, Aunger RV, 2009. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res 24: 655–673.
-
33.
Wolf-Peter S, Robert A, Yolande C, Peninnah Mukiri M, Carol Nkatha M, Adam B, Val C, 2009. Determinants of handwashing practices in Kenya: the role of media exposure, poverty and infrastructure. Trop Med Int Health 14: 1534–1541.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 332 | 332 | 43 |
| Full Text Views | 3188 | 910 | 6 |
| PDF Downloads | 624 | 81 | 5 |