Author:
ProCite
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Reference Manager
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-
1.
Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA, 2008. Handwashing for preventing diarrhoea. Cochrane Database Syst Rev 1: CD004265.
-
2.
Rabie T, Curtis V, 2006. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health 11: 258–267.
-
3.
Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM, 2005. Effect of handwashing on child health: a randomised controlled trial. Lancet 366: 225–233.
-
4.
Lim SS et al. 2012. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2224–2260.
-
5.
Bryce J, Boschi-Pinto C, Shibuya K, Black RE; WHO Child Health Epidemiology Reference Group, 2005. WHO estimates of the causes of death in children. Lancet 365: 1147–1152.
-
6.
Black RE, Morris SS, Bryce J, 2003. Where and why are 10 million children dying every year? Lancet 361: 2226–2234.
-
7.
Murray CJ et al. 2012. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2197–2223.
-
8.
Schmidt WP, 2014. The elusive effect of water and sanitation on the global burden of disease. Trop Med Int Health 19: 522–527.
-
9.
Ram P, 2013. Practical Guidance for Measuring Handwashing Behavior: 2013 Update. Washington, DC: World Bank, Water and Sanitation Program.
-
10.
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 Zaïre. Trop Med Int Health 2: 1015–1021.
-
11.
Curtis V, Cousens S, Mertens T, Traore E, Kanki B, Diallo I, 1993. Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility. Bull World Health Organ 71: 23–32.
-
12.
Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston R, Luby SP, 2010. Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh. BMC Public Health 10: 545.
-
13.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169–170.
-
14.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67–71.
-
15.
Munger K, Harris SJ, 1989. Effects of an observer on handwashing in a public restroom. Percept Mot Skills 69: 733–734.
-
16.
Ram PK et al. 2010. Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation. Am J Trop Med Hyg 83: 1070–1076.
-
17.
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: 765–771.
-
18.
Kaltenthaler EC, Pinfold JV, 1995. Microbiological methods for assessing handwashing practice in hygiene behaviour studies. J Trop Med Hyg 98: 101–106.
-
19.
Ram PK, Jahid I, Halder AK, Nygren B, Islam MS, Granger SP, Molyneaux JW, Luby SP, 2011. Variability in hand contamination based on serial measurements: implications for assessment of hand-cleansing behavior and disease risk. Am J Trop Med Hyg 84: 510–516.
-
20.
Luby SP, Halder AK, 2008. Associations among handwashing indicators, wealth, and symptoms of childhood respiratory illness in urban Bangladesh. Trop Med Int Health 13: 835–844.
-
21.
Luby SP, Halder AK, Huda TM, Unicomb L, Johnston RB, 2011. Using child health outcomes to identify effective measures of handwashing. Am J Trop Med Hyg 85: 882–892.
-
22.
Kamm KB, Feikin DR, Bigogo GM, Aol G, Audi A, Cohen AL, Shah MM, Yu J, Breiman RF, Ram PK, 2014. Associations between presence of handwashing stations and soap in the home and diarrhoea and respiratory illness, in children less than five years old in rural western Kenya. Trop Med Int Health 19: 398–406.
-
23.
Doshi S et al. 2015. Household-level risk factors for influenza among young children in Dhaka, Bangladesh: a case-control study. Trop Med Int Health 20: 719–729.
-
24.
Nizame FA, Nasreen S, Halder AK, Arman S, Winch PJ, Unicomb L, Luby SP, 2015. Observed practices and perceived advantages of different hand cleansing agents in rural Bangladesh: ash, soil, and soap. Am J Trop Med Hyg 92: 1111–1116.
-
25.
Verplanken B, Orbell S, 2003. Reflections on past behavior: a self‐report index of habit strength. J Appl Soc Psychol 33: 1313–1330.
-
26.
Vyas S, Kumaranayake L, 2006. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21: 459–468.
-
27.
Wood W, Neal DT, 2007. A new look at habits and the habit-goal interface. Psychol Rev 114: 843–863.
-
28.
Verplanken B, Wood W, 2006. Interventions to break and create consumer habits. J Public Pol Mark 25: 90–103.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 54 | 54 | 12 |
| Full Text Views | 535 | 119 | 1 |
| PDF Downloads | 183 | 48 | 0 |
Serial Measurements of Soap Weights and Soap Availability to Describe Handwashing Behavior
Meghana A. Gadgil
Meghana A. Gadgil
Center for Innovation in Global Health, Stanford University, Stanford, California;
School of Public Health and Health Professions, University at Buffalo, Buffalo, New York;
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School of Public Health and Health Professions, University at Buffalo, Buffalo, New York;
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Yushuf Sharker
Yushuf Sharker
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Leanne Unicomb
Leanne Unicomb
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Pavani K. Ram
Pavani K. Ram
School of Public Health and Health Professions, University at Buffalo, Buffalo, New York;
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Stephen P. Luby
Stephen P. Luby
Center for Innovation in Global Health, Stanford University, Stanford, California;
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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PubMed
Available measures of handwashing are prone to bias. We tested the feasibility and reliability of weighing soap at repeated visits and subtracting the measured weight from the prior weight to assess daily per capita soap consumption in a low-income community in Dhaka, Bangladesh. Fieldworkers approached 220 households twice weekly over 2 months. They interviewed participants, weighed soap, and assessed hand cleanliness and the presence of a handwashing station. Respondents used bar soap (91% [201]) and laundry detergent cakes (39% [85]) for handwashing as well as for bathing and laundry. Ninety-eight percent of households had bar soap present on at least one visit, although only 50% had bar soap at every visit during the 2-month period. Fieldworkers observed a soap fragment on the wall near the latrine in 27% (470) of visits. Households consumed a mean 1.5 g of bar soap and 3.2 g detergent cake per person per day. Daily per capita soap consumption was similar in households visited by fieldworkers after different intervals (2, 3, 4, or 5 days). Soap consumption was not associated with household wealth, education of the household head, the presence of a handwashing station, the presence of water or soap at a handwashing station, or palm inspections of the mother or child. Soap weight measurements were an objective, reliable measure of soap consumption that provided different information from other handwashing indicators. The frequent use of a soap product for purposes other than handwashing complicates using soap consumption as a handwashing measure.
Author Notes
Financial support: This study was financially supported by the U.S. Centers for Disease Control, the U.S. State Department, Fulbright Scholar Program, and the Stanford University Center for Innovation in Global Health. The conclusions are the authors’ own and should not be construed as official position of the U.S. Government.
Disclosure: S. P. L. has provided consultation to Procter & Gamble, a multinational soap manufacturer, within the last 5 years.
Authors’ addresses: Meghana A. Gadgil, Dell Medical School, University at Texas at Austin, Austin, TX, E-mail: meghana.gadgil@austin.utexas.edu. Yushuf Sharker, Yale School of Medicine, Haven, CT, E-mail: yushuf.sharker@yale.edu. Leanne Unicomb, International Center for Diarrheal Disease Research, Dhaka, Bangladesh, E-mail: leanne@icddrb.org. Pavani K. Ram, University at Buffalo School of Public Health and Health Professions, Buffalo, NY, E-mail: pkram@buffalo.edu. Stephen P. Luby, Center for Innovation in Global Health, Stanford University, Stanford, CA, E-mail: sluby@stanford.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA, 2008. Handwashing for preventing diarrhoea. Cochrane Database Syst Rev 1: CD004265.
-
2.
Rabie T, Curtis V, 2006. Handwashing and risk of respiratory infections: a quantitative systematic review. Trop Med Int Health 11: 258–267.
-
3.
Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM, 2005. Effect of handwashing on child health: a randomised controlled trial. Lancet 366: 225–233.
-
4.
Lim SS et al. 2012. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2224–2260.
-
5.
Bryce J, Boschi-Pinto C, Shibuya K, Black RE; WHO Child Health Epidemiology Reference Group, 2005. WHO estimates of the causes of death in children. Lancet 365: 1147–1152.
-
6.
Black RE, Morris SS, Bryce J, 2003. Where and why are 10 million children dying every year? Lancet 361: 2226–2234.
-
7.
Murray CJ et al. 2012. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2197–2223.
-
8.
Schmidt WP, 2014. The elusive effect of water and sanitation on the global burden of disease. Trop Med Int Health 19: 522–527.
-
9.
Ram P, 2013. Practical Guidance for Measuring Handwashing Behavior: 2013 Update. Washington, DC: World Bank, Water and Sanitation Program.
-
10.
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 Zaïre. Trop Med Int Health 2: 1015–1021.
-
11.
Curtis V, Cousens S, Mertens T, Traore E, Kanki B, Diallo I, 1993. Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility. Bull World Health Organ 71: 23–32.
-
12.
Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston R, Luby SP, 2010. Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh. BMC Public Health 10: 545.
-
13.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169–170.
-
14.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67–71.
-
15.
Munger K, Harris SJ, 1989. Effects of an observer on handwashing in a public restroom. Percept Mot Skills 69: 733–734.
-
16.
Ram PK et al. 2010. Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation. Am J Trop Med Hyg 83: 1070–1076.
-
17.
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: 765–771.
-
18.
Kaltenthaler EC, Pinfold JV, 1995. Microbiological methods for assessing handwashing practice in hygiene behaviour studies. J Trop Med Hyg 98: 101–106.
-
19.
Ram PK, Jahid I, Halder AK, Nygren B, Islam MS, Granger SP, Molyneaux JW, Luby SP, 2011. Variability in hand contamination based on serial measurements: implications for assessment of hand-cleansing behavior and disease risk. Am J Trop Med Hyg 84: 510–516.
-
20.
Luby SP, Halder AK, 2008. Associations among handwashing indicators, wealth, and symptoms of childhood respiratory illness in urban Bangladesh. Trop Med Int Health 13: 835–844.
-
21.
Luby SP, Halder AK, Huda TM, Unicomb L, Johnston RB, 2011. Using child health outcomes to identify effective measures of handwashing. Am J Trop Med Hyg 85: 882–892.
-
22.
Kamm KB, Feikin DR, Bigogo GM, Aol G, Audi A, Cohen AL, Shah MM, Yu J, Breiman RF, Ram PK, 2014. Associations between presence of handwashing stations and soap in the home and diarrhoea and respiratory illness, in children less than five years old in rural western Kenya. Trop Med Int Health 19: 398–406.
-
23.
Doshi S et al. 2015. Household-level risk factors for influenza among young children in Dhaka, Bangladesh: a case-control study. Trop Med Int Health 20: 719–729.
-
24.
Nizame FA, Nasreen S, Halder AK, Arman S, Winch PJ, Unicomb L, Luby SP, 2015. Observed practices and perceived advantages of different hand cleansing agents in rural Bangladesh: ash, soil, and soap. Am J Trop Med Hyg 92: 1111–1116.
-
25.
Verplanken B, Orbell S, 2003. Reflections on past behavior: a self‐report index of habit strength. J Appl Soc Psychol 33: 1313–1330.
-
26.
Vyas S, Kumaranayake L, 2006. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21: 459–468.
-
27.
Wood W, Neal DT, 2007. A new look at habits and the habit-goal interface. Psychol Rev 114: 843–863.
-
28.
Verplanken B, Wood W, 2006. Interventions to break and create consumer habits. J Public Pol Mark 25: 90–103.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 54 | 54 | 12 |
| Full Text Views | 535 | 119 | 1 |
| PDF Downloads | 183 | 48 | 0 |