title: Observed Handwashing with Soap Practices Among Cholera Patients and Accompanying Household Members in a Hospital Setting (CHoBI7 Trial).
abstract: Household members of cholera patients are at a 100 times higher risk of cholera than the general population. Despite this risk, there are only a handful of studies that have investigated the handwashing practices among hospitalized diarrhea patients and their accompanying household members. To investigate handwashing practices in a hospital setting among this high-risk population, 444 hours of structured observation was conducted in a hospital in Dhaka, Bangladesh, among 148 cholera patients and their household members. Handwashing with soap practices were observed at the following key events: after toileting, after cleaning the anus of a child, after removing child feces, during food preparation, before eating, and before feeding. Spot-checks were also conducted to observe the presence of soap at bathroom areas. Overall, 4% (4/103) of key events involved handwashing with soap among cholera patients and household members during the structured observation period. This was 3% (1/37) among cholera patients and 5% (3/66) for household members. For toileting events, observed handwashing with soap was 7% (3/46) overall, 7% (1/14) for cholera patients, and 6% (2/32) for household members. For food-related events, overall observed handwashing with soap was 2% (2/93 overall), and 0% (0/34) and 3% (2/59) for cholera patients and household members, respectively. Soap was observed at only 7% (4/55) of handwashing stations used by patients and household members during spot-checks. Observed handwashing with soap at key times among patients and accompanying household members was very low. These findings highlight the urgent need for interventions to target this high-risk population.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Fatema
authors.initials: F
authors.lastname: Zohura
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Sazzadul Islam
authors.initials: SI
authors.lastname: Bhuyian
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Shirajum
authors.initials: S
authors.lastname: Monira
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Farzana
authors.initials: F
authors.lastname: Begum
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Shwapon K
authors.initials: SK
authors.lastname: Biswas
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Tahmina
authors.initials: T
authors.lastname: Parvin
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: David
authors.initials: D
authors.lastname: Sack
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: R Bradley
authors.initials: RB
authors.lastname: Sack
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Elli
authors.initials: E
authors.lastname: Leontsini
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: K M
authors.initials: KM
authors.lastname: Saif-Ur-Rahman
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Mahamud-Ur
authors.initials: MU
authors.lastname: Rashid
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Rumana
authors.initials: R
authors.lastname: Sharmin
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Xiaotong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Munirul
authors.initials: M
authors.lastname: Alam
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. cmgeorge@jhsph.edu.
authors.forename: Christine Marie
authors.initials: CM
authors.lastname: George
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D006235:Hand Disinfection; D015438:Health Behavior; D006801:Humans; D006920:Hygiene; D007223:Infant; D008297:Male; D008875:Middle Aged; D012915:Soaps; D055815:Young Adult
chemical_list: D012915:Soaps