BACKGROUND: Diarrhoea is a common cause of morbidity and a leading cause of death among children aged less than five years, particularly in low- and middle-income countries. It is transmitted by ingesting contaminated food or drink, by direct person-to-person contact, or from contaminated hands. Hand washing is one of a range of hygiene promotion interventions that can interrupt the transmission of diarrhoea-causing pathogens. OBJECTIVES: To evaluate the effects of interventions to promote hand washing on diarrhoeal episodes in children and adults. SEARCH STRATEGY: In May 2007, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2007, Issue 2), MEDLINE, EMBASE, LILACS, PsycINFO, Science Citation Index and Social Science Citation Index, ERIC (1966 to May 2007), SPECTR, Bibliomap, RoRe, The Grey Literature, and reference lists of articles. We also contacted researchers and organizations in the field. SELECTION CRITERIA: Randomized controlled trials, where the unit of randomization is an institution (eg day-care centre), household, or community, that compared interventions to promote hand washing or a hygiene promotion that included hand washing with no intervention to promote hand washing. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial eligibility and methodological quality. Where appropriate, incidence rate ratios (IRR) were pooled using the generic inverse variance method and random-effects model with 95% confidence intervals (CI). MAIN RESULTS: Fourteen randomized controlled trials met the inclusion criteria. Eight trials were institution-based, five were community-based, and one was in a high-risk group (AIDS patients). Interventions promoting hand washing resulted in a 29% reduction in diarrhoea episodes in institutions in high-income countries (IRR 0.71, 95% CI 0.60 to 0.84; 7 trials) and a 31% reduction in such episodes in communities in low- or middle-income countries (IRR 0.69, 95% CI 0.55 to 0.87; 5 trials). AUTHORS' CONCLUSIONS: Hand washing can reduce diarrhoea episodes by about 30%. This significant reduction is comparable to the effect of providing clean water in low-income areas. However, trials with longer follow up and that test different methods of promoting hand washing are needed.
BACKGROUND:Diarrhoea is a common cause of morbidity and a leading cause of death among children aged less than five years, particularly in low- and middle-income countries. It is transmitted by ingesting contaminated food or drink, by direct person-to-person contact, or from contaminated hands. Hand washing is one of a range of hygiene promotion interventions that can interrupt the transmission of diarrhoea-causing pathogens. OBJECTIVES: To evaluate the effects of interventions to promote hand washing on diarrhoeal episodes in children and adults. SEARCH STRATEGY: In May 2007, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2007, Issue 2), MEDLINE, EMBASE, LILACS, PsycINFO, Science Citation Index and Social Science Citation Index, ERIC (1966 to May 2007), SPECTR, Bibliomap, RoRe, The Grey Literature, and reference lists of articles. We also contacted researchers and organizations in the field. SELECTION CRITERIA: Randomized controlled trials, where the unit of randomization is an institution (eg day-care centre), household, or community, that compared interventions to promote hand washing or a hygiene promotion that included hand washing with no intervention to promote hand washing. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial eligibility and methodological quality. Where appropriate, incidence rate ratios (IRR) were pooled using the generic inverse variance method and random-effects model with 95% confidence intervals (CI). MAIN RESULTS: Fourteen randomized controlled trials met the inclusion criteria. Eight trials were institution-based, five were community-based, and one was in a high-risk group (AIDSpatients). Interventions promoting hand washing resulted in a 29% reduction in diarrhoea episodes in institutions in high-income countries (IRR 0.71, 95% CI 0.60 to 0.84; 7 trials) and a 31% reduction in such episodes in communities in low- or middle-income countries (IRR 0.69, 95% CI 0.55 to 0.87; 5 trials). AUTHORS' CONCLUSIONS: Hand washing can reduce diarrhoea episodes by about 30%. This significant reduction is comparable to the effect of providing clean water in low-income areas. However, trials with longer follow up and that test different methods of promoting hand washing are needed.
Authors: Pavani K Ram; Amal K Halder; Stewart P Granger; Therese Jones; Peter Hall; David Hitchcock; Richard Wright; Benjamin Nygren; M Sirajul Islam; John W Molyneaux; Stephen P Luby Journal: Am J Trop Med Hyg Date: 2010-11 Impact factor: 2.345
Authors: Fosiul A Nizame; Sharifa Nasreen; Amal K Halder; Shaila Arman; Peter J Winch; Leanne Unicomb; Stephen P Luby Journal: Am J Trop Med Hyg Date: 2015-04-13 Impact factor: 2.345
Authors: J R Cope; A Prosser; S Nowicki; M W Roberts; J M Roberts; D Scheer; C Anderson; A Longsworth; C Parsons; D Goldschmidt; S Johnston; H Bishop; L Xiao; V Hill; M Beach; M C Hlavsa Journal: Epidemiol Infect Date: 2015-04-24 Impact factor: 2.451
Authors: Sandy Cairncross; Caroline Hunt; Sophie Boisson; Kristof Bostoen; Val Curtis; Isaac C H Fung; Wolf-Peter Schmidt Journal: Int J Epidemiol Date: 2010-04 Impact factor: 7.196
Authors: William E Oswald; Gabrielle C Hunter; Andres G Lescano; Lilia Cabrera; Elli Leontsini; William K Pan; Valerie Paz Soldan; Robert H Gilman Journal: Trop Med Int Health Date: 2008-11 Impact factor: 2.622
Authors: Joanne E McKenzie; Patricia Priest; Rick Audas; Marion R Poore; Cheryl R Brunton; Lesley M Reeves Journal: Trials Date: 2010-01-23 Impact factor: 2.279