Using Child Health Outcomes to Identify Effective Measures of Handwashing

We assessed which practical handwashing indicators were independently associated with reduced child diarrhea or respiratory disease. Fieldworkers collected 33 indicators of handwashing at baseline in 498 households in 50 villages in rural Bangladesh. Community monitors visited households monthly and...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2011-11, Vol.85 (5), p.882-892
Main Authors: LUBY, Stephen P, HALDER, Amal K, HUDA, Tarique M. N, UNICOMB, Leanne, JOHNSTON, Richard B
Format: Article
Language:English
Subjects:
Adult
Bangladesh - epidemiology
Biological and medical sciences
Child Welfare
Child, Preschool
Communicable Disease Control - methods
Cross-Sectional Studies
Diarrhea - epidemiology
Diarrhea - prevention & control
Education
Epidemiology. Vaccinations
Female
General aspects
Hand Disinfection - methods
Hand Disinfection - standards
Health Education
Humans
Infectious diseases
Male
Medical sciences
Respiratory Tract Infections - epidemiology
Respiratory Tract Infections - prevention & control
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Summary:We assessed which practical handwashing indicators were independently associated with reduced child diarrhea or respiratory disease. Fieldworkers collected 33 indicators of handwashing at baseline in 498 households in 50 villages in rural Bangladesh. Community monitors visited households monthly and asked standard questions about diarrhea and symptoms of respiratory illness among children under 5 years of age. In multivariate analysis, three handwashing indicators were independently associated with less child diarrhea-mothers reporting usually washing hands with soap before feeding a child, mothers using soap when asked to show how they usually washed their hands after defecation, and children having visibly clean finger pads. Two indicators were independently associated with fewer respiratory infections-mothers allowing their hands to air dry after the handwashing demonstration and the presence of water where the respondents usually wash hands after defecation. These rapid handwashing indicators should be considered for inclusion in handwashing assessments.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.2011.11-0142