International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Trop Med Int Health. 2010 Dec;15(12):1508-16. doi: 10.1111/j.1365-3156.2010.02648.x. Epub 2010 Oct 19.
To pilot two intensive hand hygiene promotion interventions, one using soap and one using a waterless hand sanitizer, in low-income housing compounds in Dhaka, Bangladesh and assess subsequent changes in handwashing behaviour and hand microbiology.
Fieldworkers randomized 30 housing compounds: 10 received handwashing promotion with free soap, 10 received handwashing promotion with free waterless hand sanitizer and 10 were non-intervention controls. Fieldworkers assessed handwashing behaviour by structured observation and collected hand rinse specimens.
At baseline, compound residents washed their hands with soap 26% of the time after defecation and 30% after cleaning a child's anus but <1% at other times. Compared with baseline, residents of soap intervention compounds were much more likely to wash their hands with soap after faecal contact (85-91%), before preparing food (26%) and before eating (26%). Compounds that received waterless hand sanitizer cleansed their hands more commonly than control compounds that used soap (10.4%vs. 2.3%), but less commonly than soap intervention compounds used soap (25%). Post-intervention hand rinse samples from soap and sanitizer compounds had lower concentrations of faecal indicator bacteria compared with baseline and control compounds.
Waterless hand sanitizer was readily adopted by this low-income community and reduced hand contamination but did not improve the frequency of handwashing compared with soap. Future deployments of waterless hand sanitizers may improve hand hygiene more effectively by targeting settings where soap and water is unavailable.
在孟加拉国达卡的低收入住房区内试行两种强化手部卫生促进干预措施，一种使用肥皂，另一种使用无水手部消毒剂，并评估随后的洗手行为和手部微生物学变化。
现场工作人员将 30 个住房区随机分组：10 个组接受免费肥皂的洗手促进，10 个组接受免费无水手部消毒剂的洗手促进，10 个组为非干预对照。现场工作人员通过结构化观察评估洗手行为，并收集手部冲洗样本。
在基线时，社区居民在便后用肥皂洗手的频率为 26%，在清洁儿童肛门后为 30%，但在其他时间洗手的频率<1%。与基线相比，肥皂干预组的居民在接触粪便后（85-91%）、在准备食物前（26%）和在进食前（26%）更有可能用肥皂洗手。使用无水手部消毒剂的化合物比使用肥皂的对照组更频繁地清洁手部（10.4%对 2.3%），但比使用肥皂的肥皂干预组更不频繁（25%）。与基线和对照组相比，肥皂和消毒剂化合物的手部冲洗样本中粪便指示菌的浓度较低。
无水手部消毒剂很容易被这个低收入社区采用，并减少手部污染，但与肥皂相比，并没有提高洗手的频率。未来无水手部消毒剂的部署可能会通过针对肥皂和水无法使用的环境来更有效地改善手部卫生。
