title: Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan.
abstract: We conducted a study in a squatter settlement in Karachi, Pakistan where residents report commonly washing their hands to determine if providing soap, encouraging hand washing, and improving wash-water quality would improve hand cleanliness. We allocated interventions to 75 mothers and collected hand-rinse samples on unannounced visits. In the final model compared with mothers who received no hand-washing intervention, mothers who received soap would be expected to have 65% fewer thermotolerant coliform bacteria on their hands (95% CI 40%, 79%) and mothers who received soap, a safe water storage vessel, hypochlorite for water treatment, and instructions to wash their hands with soap and chlorinated water would be expected to have 74% fewer (95% CI 57%, 84%). The difference between those who received soap alone, and those who received soap plus the safe water vessel was not significant (P = 0.26). Providing soap and promoting hand washing measurably improved mothers' hand cleanliness even when used with contaminated water.
authors.affiliation: Community Health Sciences, Aga Khan University, Karachi, Pakistan.
authors.forename: S P
authors.initials: SP
authors.lastname: Luby
authors.forename: M
authors.initials: M
authors.lastname: Agboatwalla
authors.forename: A
authors.initials: A
authors.lastname: Raza
authors.forename: J
authors.initials: J
authors.lastname: Sobel
authors.forename: E D
authors.initials: ED
authors.lastname: Mintz
authors.forename: K
authors.initials: K
authors.lastname: Baier
authors.forename: R M
authors.initials: RM
authors.lastname: Hoekstra
authors.forename: M H
authors.initials: MH
authors.lastname: Rahbar
authors.forename: R
authors.initials: R
authors.lastname: Hassan
authors.forename: S M
authors.initials: SM
authors.lastname: Qureshi
authors.forename: E J
authors.initials: EJ
authors.lastname: Gangarosa
mesh_terms: D005260:Female; D006235:Hand Disinfection; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D010154:Pakistan; D011203:Poverty; D012915:Soaps; D014505:Urban Population; D014881:Water Supply
chemical_list: D012915:Soaps