Effect of Intensive Handwashing Promotion on Childhood Diarrhea in High-Risk Communities in Pakistan

Abstract

EARLY 2 MILLION CHILDREN die annually from diarrheal disease. 1 A recent metaanalysis concluded that handwashing promotion interventions decrease diarrhea by a mean of 47%. 2 The authors estimate that such interventions could prevent 1 million child deaths per year. 2 However, the systematic meta-analysis and the studies it included summarized the reduction in diarrheal rates among all children or all family members. But all family members are not at equal risk of death from diarrhea. Children younger than 5 years are at much higher risk of death from diarrhea than older children and adults, 1 and infants (younger than 1 year) are at the highest risk of death. Verbal autopsy studies from Egypt, 3 Pakistan, 4 Bangladesh, 5 and Ethiopia 6 report that 43% to 78% of deaths from diarrhea among children younger than 5 years occur in the first year of life.Infants cannot wash their own hands and therefore cannot interrupt the transfer of pathogens between their hands and their mouth. Infants might benefit from a lower rate of diarrheal pathogen transmission from parents and siblings who wash their hands more

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“…147 " 149 h. After contact with blood or bodily fluids. 213,214 i. After contact with the patient environment.…”

Non Medical Interventions for Childhood Diarrhoea Control:Way Forward in Nepal

“…Moreover, the intervention had the major positive effects on those children who were suffering from moderate to severe malnutrition (statistics not provided in the evaluation study). 20 The study showed the positive hopes in the social and behavioural intervention of the diarrhoeal control in children. Luby et al in their follow up in 2009 reported that sustainability of the project was limited.…”

“…20 The incidence of diarrhoea was lowered by 53% (95 % CI, -65% to -41%) in the intervention areas. 20 The duration of illness was also reduced by 39% (counted in days).…”

“…20 The incidence of diarrhoea was lowered by 53% (95 % CI, -65% to -41%) in the intervention areas. 20 The duration of illness was also reduced by 39% (counted in days). Moreover, the intervention had the major positive effects on those children who were suffering from moderate to severe malnutrition (statistics not provided in the evaluation study).…”

“…20 The study area was a low sanitation area having high childhood mortality from diarrhoeal disease, high level of water contamination from human feaces, and with no prior targeted interventions for hand washing. The study included two tier interventions; the first was hand washing promotion and the second was supply of soaps for hand washing.…”