title: Associations between presence of handwashing stations and soap in the home and diarrhoea and respiratory illness, in children less than five years old in rural western Kenya.
abstract: OBJECTIVE
  We tested whether soap presence in the home or a designated handwashing station was associated with diarrhoea and respiratory illness in Kenya.
  
  
  METHODS
  In April 2009, we observed presence of a handwashing station and soap in households participating in a longitudinal health surveillance system in rural Kenya. Diarrhoea and acute respiratory illness (ARI) in children < 5 years old were identified using parent-reported syndromic surveillance collected January-April 2009. We used multivariate generalised linear regression to estimate differences in prevalence of illness between households with and without the presence of soap in the home and a handwashing station.
  
  
  RESULTS
  Among 2547 children, prevalence of diarrhoea and ARI was 2.3 and 11.4 days per 100 child-days, respectively. Soap was observed in 97% of households. Children in households with soap had 1.3 fewer days of diarrhoea/100 child-days (95% CI -2.6, -0.1) than children in households without soap. ARI prevalence was not associated with presence of soap. A handwashing station was identified in 1.4% of households and was not associated with a difference in diarrhoea or ARI prevalence.
  
  
  CONCLUSIONS
  Soap presence in the home was significantly associated with reduced diarrhoea, but not ARI, in children in rural western Kenya. Whereas most households had soap in the home, almost none had a designated handwashing station, which may prevent handwashing at key times of hand contamination.
authors.affiliation: University at Buffalo, SUNY, Buffalo, NY, USA.
authors.forename: K B
authors.initials: KB
authors.lastname: Kamm
authors.forename: D R
authors.initials: DR
authors.lastname: Feikin
authors.forename: G M
authors.initials: GM
authors.lastname: Bigogo
authors.forename: G
authors.initials: G
authors.lastname: Aol
authors.forename: A
authors.initials: A
authors.lastname: Audi
authors.forename: A L
authors.initials: AL
authors.lastname: Cohen
authors.forename: M M
authors.initials: MM
authors.lastname: Shah
authors.forename: J
authors.initials: J
authors.lastname: Yu
authors.forename: R F
authors.initials: RF
authors.lastname: Breiman
authors.forename: P K
authors.initials: PK
authors.lastname: Ram
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006235:Hand Disinfection / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012111:Residence Characteristics; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000517:prevention & control*; D012423:Rural Health; D012915:Soaps / Q000600:supply & distribution*; D014881:Water Supply / Q000706:statistics & numerical data*
chemical_list: D012915:Soaps
keywords: Kenya; acute respiratory infection; diarrhoea; handwashing