title: How effective is good domestic kitchen hygiene at reducing diarrhoeal disease in developed countries? A systematic review and reanalysis of the UK IID study.
abstract: BACKGROUND
  To assess whether domestic kitchen hygiene is an important contributor to the development of diarrhoea in the developed world.
  
  
  METHODS
  Electronic searches were carried out in October 2006 in EMBASE, MEDLINE, Web of Knowledge, Cochrane central register of clinical trials and CINAHL. All publications, irrespective of study design, assessing food hygiene practices with an outcome measure of diarrhoea were included in the review. All included studies underwent data extraction and the data was subsequently analysed. The analysis was conducted by qualitative synthesis of the results. Given the substantial heterogeneity in study design and outcome measures meta-analysis was not done. In addition the existing dataset of the UK IID study was reanalysed to investigate possible associations between self-reported diarrhoea and variables indicative of poor domestic kitchen hygiene
  
  
  RESULTS
  Some 14 studies were finally included in subsequent analyses. Of the 14 studies included in this systematic review, 11 were case-control studies, 2 cross-sectional surveys, and 1 RCT. Very few studies identified any significant association with good environmental kitchen hygiene. Although some of the variables in the reanalysis of the UK IID study were statistically significant no obvious trend was seen.
  
  
  CONCLUSIONS
  The balance of the available evidence does not support the hypothesis that poor domestic kitchen hygiene practices are important risk factors for diarrhoeal disease in developed countries.
authors.affiliation: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK. annastenberg80@hotmail.com
authors.forename: Anna
authors.initials: A
authors.lastname: Stenberg
authors.forename: Clare
authors.initials: C
authors.lastname: Macdonald
authors.forename: Paul R
authors.initials: PR
authors.lastname: Hunter
mesh_terms: D003296:Cooking; D019049:Developed Countries; D003967:Diarrhea / Q000382:microbiology / Q000517:prevention & control*; D005506:Food Contamination / Q000517:prevention & control; D006801:Humans; D006920:Hygiene / Q000592:standards*; D012499:Sanitation; D006113:United Kingdom