Am J Trop Med Hyg. 2012 Sep;87(3):385-393. doi: 10.4269/ajtmh.2012.11-0633. Epub 2012 Jul 16.
Handwashing with soap effectively reduces exposure to diarrhea-causing pathogens. Interventions to improve hygiene and sanitation conditions in schools within low-income countries have gained increased attention; however, their impact on schoolchildren's exposure to fecal pathogens has not been established. Our trial examined whether a school-based water, sanitation, and hygiene intervention reduced Escherichia coli contamination on pupils' hands in western Kenya. A hygiene promotion and water treatment intervention did not reduce risk of E. coli presence (relative risk [RR] = 0.92, 95% confidence interval [CI] = 0.54-1.56); the addition of new latrines to intervention schools significantly increased risk among girls (RR = 2.63, 95% CI = 1.29-5.34), with a non-significant increase among boys (RR = 1.36, 95% CI = 0.74-2.49). Efforts to increase usage of school latrines by constructing new facilities may pose a risk to children in the absence of sufficient hygiene behavior change, daily provision of soap and water, and anal cleansing materials.
用肥皂洗手可以有效地减少接触引起腹泻的病原体。在低收入国家，改善学校卫生和环境卫生条件的干预措施得到了更多关注；然而，它们对学童接触粪便病原体的影响尚未确定。我们的试验研究了基于学校的水、卫生和个人卫生干预措施是否能减少肯尼亚西部学童手上的大肠杆菌污染。卫生促进和水处理干预并没有降低大肠杆菌存在的风险（相对风险 [RR] = 0.92，95%置信区间 [CI] = 0.54-1.56）；在干预学校增加新的厕所显著增加了女孩的风险（RR = 2.63，95%CI = 1.29-5.34），男孩的风险则略有增加（RR = 1.36，95%CI = 0.74-2.49）。如果没有足够的卫生行为改变、每天提供肥皂和水以及肛门清洁材料，仅仅通过建造新的设施来增加学校厕所的使用可能会对儿童构成风险。
