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Hand-washing promotion for preventing diarrhoea.

ABSTRACT:

SUBMITTER: Ejemot-Nwadiaro RI

PROVIDER: S-EPMC8094449 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Hand-washing promotion for preventing diarrhoea.

Ejemot-Nwadiaro Regina I RI Ehiri John E JE Arikpo Dachi D Meremikwu Martin M MM Critchley Julia A JA

The Cochrane database of systematic reviews 20210106

<h4>Background</h4>Diarrhoea accounts for 1.8 million deaths in children in low- and middle-income countries (LMICs). One of the identified strategies to prevent diarrhoea is hand washing.<h4>Objectives</h4>To assess the effects of hand-washing promotion interventions on diarrhoeal episodes in children and adults.<h4>Search methods</h4>We searched CENTRAL, MEDLINE, Embase, nine other databases, the World Health Organization (WHO) International Clinical Trial Registry Platform (ICTRP), and metaRe ...[more]

PMID: 33539552

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Project description:BackgroundInformation on the impact of hygiene interventions on severe outcomes is limited. As a pre-specified secondary outcome of a cluster-randomized controlled trial among >400 000 low-income residents in Dhaka, Bangladesh, we examined the impact of cholera vaccination plus a behaviour change intervention on diarrhoea-associated hospitalization.MethodsNinety neighbourhood clusters were randomly allocated into three areas: cholera-vaccine-only; vaccine-plus-behaviour-change (promotion of hand-washing with soap plus drinking water chlorination); and control. Study follow-up continued for 2 years after intervention began. We calculated cluster-adjusted diarrhoea-associated hospitalization rates using data we collected from nearby hospitals, and 6-monthly census data of all trial households.ResultsA total of 429 995 people contributed 500 700 person-years of data (average follow-up 1.13 years). Vaccine coverage was 58% at the start of analysis but continued to drop due to population migration. In the vaccine-plus-behaviour-change area, water plus soap was present at 45% of hand-washing stations; 4% of households had detectable chlorine in stored drinking water. Hospitalization rates were similar across the study areas [events/1000 person-years, 95% confidence interval (CI), cholera-vaccine-only: 9.4 (95% CI: 8.3-10.6); vaccine-plus-behaviour-change: 9.6 (95% CI: 8.3-11.1); control: 9.7 (95% CI: 8.3-11.6)]. Cholera cases accounted for 7% of total number of diarrhoea-associated hospitalizations.ConclusionsNeither cholera vaccination alone nor cholera vaccination combined with behaviour-change intervention efforts measurably reduced diarrhoea-associated hospitalization in this highly mobile population, during a time when cholera accounted for a small fraction of diarrhoea episodes. Affordable community-level interventions that prevent infection from multiple pathogens by reliably separating faeces from the environment, food and water, with minimal behavioural demands on impoverished communities, remain an important area for research.

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Hand-washing promotion for preventing diarrhoea.

Publications

Hand-washing promotion for preventing diarrhoea.

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