Use of Electronic Loggers to Measure Changes in the Rates of Hand Washing with Soap in Low-Income Urban Households in India

Abstract

We evaluated the utility of electronic loggers to measure the effects of a simple intervention designed to influence the rates of hand washing with soap within enclosed toilets and bathrooms in low-income urban households in Kerala, India. 58 households were given three items with embedded electronic loggers for a period of 2-5 days. Two logged soaps tracked hand and body washing in the bathroom. The third logged item was a water vessel used for flushing the toilet and for post-defecation anal cleansing; this served as a marker of toilet use. In addition, 28 households in a Soap by toilet arm were given an additional logged soap, to be kept by the toilet, and used for hand washing. Compared with the Soap in bathroom arm, the loggers in the Soap by toilet households recorded 73% greater daily use of soaps designated for hand washing (t(36)=2.92, p<0.01) and 172% greater use within 2 minutes of the use of the water vessel (t(36)=3.51, p = 0.001). We conclude that the loggers were capable of detecting changes in the rates of hand washing with soap and changes in hand washing with soap after use of the toilet. Further adoption of logger technologies would enable more insightful studies of hand washing within urban environments.

Electronic Monitoring Systems for Hand Hygiene: Systematic Review of Technology

“…Most studies (50/89, 56%) recruited HCWs from hospitals or clinics [ 29 , 30 , 32 - 40 , 44 , 46 - 57 , 59 , 61 , 66 - 68 , 73 - 75 , 77 - 80 , 82 , 84 , 86 , 87 , 89 - 91 , 95 , 96 , 98 - 100 , 103 , 106 ], and few (2/89, 2%) studies also involved patients from hospitals [ 66 , 94 ]. The remaining studies recruited the general public (7/89, 8%) [ 45 , 60 , 64 , 65 , 109 - 111 ] or students (4/89, 4%) [ 76 , 104 , 114 , 115 ] from communities or educational settings.…”

“…By using acceleration, gyration, and audio signals from participants’ wrists, Wijayasingha et al [ 70 ] applied the naive Bayes algorithm to identify both hand hygiene and oral hygiene events from people with developmental disabilities. Instead of placing sensors on users’ wrists, 43% (3/7) of studies embedded IMU sensors with or without microphones inside soap bars [ 60 , 64 , 65 ]. These augmented soap bars were then distributed to low-income households to monitor their soap use associated with hand and body wash.…”

Recognition of Bathroom Activities in Older Adults Using Wearable Sensors: A Systematic Review and Recommendations

“…The other 39 papers used other types of sensors, among which audio recorders, video/image recorders, radar sensors, inertial measurement unit (IMU) sensors (accelerometer and/or gyroscope) attached to the object instead of the human body and environmental sensors. Audio recorders were used for detecting activities related to water flowing, e.g., washing hands [ 35 , 36 , 37 , 38 , 39 ], washing face [ 36 ], toileting [ 38 , 40 , 41 ] or bathing [ 40 ]. Video/image recorders were usually used for detecting washing hands [ 35 , 39 , 42 , 43 , 44 ], washing face [ 36 ] and dressing [ 45 , 46 , 47 , 48 ].…”

“…Radar sensors were used for detecting standing/sitting while showering [ 49 ], entering the bathtub [ 49 , 50 ] and sitting on/leaving toilet [ 51 ]. IMU sensors were attached to the water pipe for detecting washing and bathing [ 52 ], on the robot for detecting dressing [ 46 ], and in the soap bar for hand washing [ 37 ]. Multiple environmental sensors were combined for detecting bathing/showering [ 34 , 36 , 40 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ], toileting [ 34 , 36 , 38 , 40 , 41 , 55 , 56 , 57 , 58 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ], dressing [ 45 , 58 , 71 , 72 ], general personal hygiene activity [ 54 , 61 ], washing hands [ 36 , 37 , 38 ], washing face [ 36 ] and grooming [ 58 , 70 ].…”

Electronic Monitoring Systems for Hand Hygiene: Systematic Review of Technology (Preprint)

“…All the 89 reviewed studies were published between 2009 and 2020, with 9 (10%) dated in or before 2010 [42,46,56,60,81,83,86,92,113], 38 (43%) dated between 2011 and 2015 [32,33,36,38,39,45,48,49,51,52,54,59,61,[63][64][65]67,68,72,73,[78][79][80]82,84,[87][88][89][93][94][95][96][97][99][100][101]108,116], and 42 (47%) dated in or after 2016 [25,[29][30][31]…”