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Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan

Published online by Cambridge University Press:  26 November 2001

S. P. LUBY ,
M. AGBOATWALLA ,
A. RAZA ,
J. SOBEL ,
E. D. MINTZ ,
K. BAIER ,
R. M. HOEKSTRA ,
M. H. RAHBAR ,
R. HASSAN  and
S. M. QURESHI
...Show all authors
S. P. LUBY
Affiliation:
Community Health Sciences, Aga Khan University, Karachi, Pakistan
M. AGBOATWALLA
Affiliation:
Health Oriented Preventive Education (HOPE), Karachi Pakistan
A. RAZA
Affiliation:
Community Health Sciences, Aga Khan University, Karachi, Pakistan
J. SOBEL
Affiliation:
Foodborne and Diarrheal Diseases Branch, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
E. D. MINTZ
Affiliation:
Foodborne and Diarrheal Diseases Branch, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
K. BAIER
Affiliation:
Procter and Gamble Company, Cincinnati, OH 45241, USA
R. M. HOEKSTRA
Affiliation:
Biostatistics and Information Management Branch, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
M. H. RAHBAR
Affiliation:
Community Health Sciences, Aga Khan University, Karachi, Pakistan
R. HASSAN
Affiliation:
Department of Microbiology, Aga Khan University Hospital Laboratory, Karachi, Pakistan
S. M. QURESHI
Affiliation:
Department of Microbiology, Aga Khan University Hospital Laboratory, Karachi, Pakistan
E. J. GANGAROSA
Affiliation:
Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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Abstract

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We conducted a study in a squatter settlement in Karachi, Pakistan where residents report commonly washing their hands to determine if providing soap, encouraging hand washing, and improving wash-water quality would improve hand cleanliness. We allocated interventions to 75 mothers and collected hand-rinse samples on unannounced visits. In the final model compared with mothers who received no hand-washing intervention, mothers who received soap would be expected to have 65% fewer thermotolerant coliform bacteria on their hands (95% CI 40%, 79%) and mothers who received soap, a safe water storage vessel, hypochlorite for water treatment, and instructions to wash their hands with soap and chlorinated water would be expected to have 74% fewer (95% CI 57%, 84%). The difference between those who received soap alone, and those who received soap plus the safe water vessel was not significant (P = 0·26). Providing soap and promoting hand washing measurably improved mothers' hand cleanliness even when used with contaminated water.

Type
Research Article
Information
Epidemiology & Infection , Volume 127 , Issue 2 , October 2001 , pp. 237 - 244
Copyright
2001 Cambridge University Press