Difficulties in maintaining improved handwashing behavior, Karachi, Pakistan.
In an earlier study in Karachi, Pakistan, households that received free soap and handwashing promotion for 9 months reported 53% less diarrhea than controls. Eighteen months after the intervention ended, these households were enrolled in a follow-up study to assess sustainability of handwashing behavior. Upon re-enrollment, mothers in households originally assigned to the intervention were 1.5 times more likely to have a place with soap and water to wash hands (79% versus 53%, P = 0.001) and when asked to wash hands were 2.2 times more likely to rub their hands together at least three times (50% versus 23%, P = 0.002) compared with controls. In the ensuing 14 months, former intervention households reported a similar proportion of person-days with diarrhea (1.59% versus 1.88%, P = 0.66) as controls. Although intervention households showed better handwashing technique after 2 years without intervention, their soap purchases and diarrhea experience was not significantly different from controls.
Luby
Stephen P
SP
International Centre for Diarrhoeal Disease, Bangladesh, Dhaka, Bangladesh. sluby@icddrb.org
Agboatwalla
Mubina
M
Bowen
Anna
A
Kenah
Eben
E
Sharker
Yushuf
Y
Hoekstra
Robert M
RM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000517:prevention & control; D006235:Hand Disinfection; D006801:Humans; D007223:Infant; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence