Impact of a school-based hygiene promotion and sanitation intervention on pupil hand contamination in Western Kenya: a cluster randomized trial.
Handwashing with soap effectively reduces exposure to diarrhea-causing pathogens. Interventions to improve hygiene and sanitation conditions in schools within low-income countries have gained increased attention; however, their impact on schoolchildren's exposure to fecal pathogens has not been established. Our trial examined whether a school-based water, sanitation, and hygiene intervention reduced Escherichia coli contamination on pupils' hands in western Kenya. A hygiene promotion and water treatment intervention did not reduce risk of E. coli presence (relative risk [RR] = 0.92, 95% confidence interval [CI] = 0.54-1.56); the addition of new latrines to intervention schools significantly increased risk among girls (RR = 2.63, 95% CI = 1.29-5.34), with a non-significant increase among boys (RR = 1.36, 95% CI = 0.74-2.49). Efforts to increase usage of school latrines by constructing new facilities may pose a risk to children in the absence of sufficient hygiene behavior change, daily provision of soap and water, and anal cleansing materials.
Leslie E
LE
Greene
Matthew C
MC
Freeman
Daniel
D
Akoko
Shadi
S
Saboori
Christine
C
Moe
Richard
R
Rheingans
D000293:Adolescent; D002648:Child; D016000:Cluster Analysis; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D004926:Escherichia coli / Q000187:drug effects / Q000472:pathogenicity; D005260:Female; D005500:Follow-Up Studies; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D006920:Hygiene / Q000592:standards*; D007630:Kenya / Q000453:epidemiology; D008297:Male; D011203:Poverty; D012307:Risk Factors; D012499:Sanitation / Q000379:methods*; D012574:Schools; D012915:Soaps; D014038:Toilet Facilities / Q000592:standards
D012915:Soaps