title: Clean hands: prevention of typhoid fever in rural communities in Egypt.
abstract: Typhoid fever is a serious public health problem in Egypt. Effective prevention strategies include the promotion of handwashing. This study explores factors that influence handwashing practices in the Egyptian setting and makes recommendations on how to use this information in a handwashing campaign. In addition to key informant interviews, 16 focus group discussions and 21 in-depth interviews were carried out with female respondents in three different rural sites. The data was analyzed by using content analysis technique. The findings showed that the concept of dirt (microbaat and talaus) influences hygiene behavior as it relates to the outside (i.e., real and visible things). The respondents have low risk perceptions related to typhoid fever and they do not conceptualize long disease transmission chains. The scarcity of water and problems with disposal of waste water hinder handwashing. These findings were incorporated into a pilot campaign to promote handwashing using strategies that included the visualization of germs in critical areas during critical times, discussions of germ theory, and encouragement to solve environmental and infrastructural constraints that hinder handwashing practices at the household level.
authors.affiliation: U. S. Naval Medical Research Unit #3, Cairo, Egypt. anna.lohiniva.ctr@med.navy.mil
authors.forename: Anna L
authors.initials: AL
authors.lastname: Lohiniva
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saeed
authors.forename: Nasr
authors.initials: N
authors.lastname: El-Sayeed
authors.forename: Maha
authors.initials: M
authors.lastname: Talaat
mesh_terms: D003153:Community Health Services; D004534:Egypt / Q000453:epidemiology; D017144:Focus Groups; D006235:Hand Disinfection; D006293:Health Promotion; D006801:Humans; D016730:Program Development; D015397:Program Evaluation; D011634:Public Health; D036301:Qualitative Research; D012307:Risk Factors; D019035:Rural Health Services; D012424:Rural Population; D014435:Typhoid Fever / Q000453:epidemiology / Q000517:prevention & control*