Sanitation Updates

The Cochrane Collaboration has published, Hand washing for preventing diarrhoea (Review), by Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA.

This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library, 2008, Issue 1

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.

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 differentmethods of promoting hand washing are needed.

Download the complete report