Hand washing for preventing diarrhoea

Regina I. Ejemot, John E Ehiri, M. M. Meremikwu, J. A. Critchley

Research output: Contribution to journalArticle

213 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article numberCD004265
JournalCochrane database of systematic reviews (Online)
Issue number1
DOIs
StatePublished - 2008
Externally publishedYes

Fingerprint

Hand Disinfection
Diarrhea
Confidence Intervals
Hygiene
Incidence
Randomized Controlled Trials
Social Sciences
Random Allocation
MEDLINE
Patient Selection
Libraries
Communicable Diseases
Cause of Death
Acquired Immunodeficiency Syndrome
Hand
Research Personnel
Organizations
Morbidity
Food
Water

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

Cite this

Hand washing for preventing diarrhoea. / Ejemot, Regina I.; Ehiri, John E; Meremikwu, M. M.; Critchley, J. A.

In: Cochrane database of systematic reviews (Online), No. 1, CD004265, 2008.

Research output: Contribution to journalArticle

Ejemot, Regina I. ; Ehiri, John E ; Meremikwu, M. M. ; Critchley, J. A. / Hand washing for preventing diarrhoea. In: Cochrane database of systematic reviews (Online). 2008 ; No. 1.
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abstract = "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.",
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