Ethiopian Institute of Water Resources (EIWR), Addis Ababa University, Addis Ababa, Ethiopia.
College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia.
J Community Health. 2018 Apr;43(2):400-405. doi: 10.1007/s10900-017-0437-1.
Adequate hand washing with soap at five recommended times is particularly important in urban slums in developing countries, but which of the recommended times are the most important in the prevention of diarrhea among children under five years of age living in these areas remains unclear. To address this gap, a community-based cross-sectional study was undertaken in the slums of Addis Ababa, Ethiopia between September and November 2014. Data were collected using a pre-tested structured questionnaire and an observational checklist. Multivariable logistic regression with 95% confidence interval (CI) was used for data analysis. Only 4.4% of the households had hand washing facilities within or near a latrine with soap and water access. The average prevalence of hand washing with soap at the five recommended times was 19.8%. One quarter (24.8%) of caregivers washed their hands with soap before feeding a child, 23.8% before preparing food, and 17.1% after defecation. The most important recommended times in preventing acute diarrhea were before preparing food [adjusted odds ratio (AOR) 0.2; 95% CI 0.1-0.7] and after defecation (AOR 0.3; 95% CI 0.1-0.9). Household size of six or more persons (AOR 2.3; 95% CI 1.4-3.9) and low monthly household income (AOR 2.4; 95% CI 1.4-4.0) were significantly associated with acute diarrhea. Promoting hand washing with soap and advocacy programs at the five recommended times, especially before preparing food and after defecation, and implementation of socioeconomic development programs targeting poor households are essential for increasing the prevalence of hand washing with soap and preventing acute diarrhea in the slums of Addis Ababa.
在发展中国家的城市贫民窟中，用肥皂充分洗手在五个推荐时间点特别重要，但在这些地区生活的五岁以下儿童中，预防腹泻，哪一个推荐时间点最为重要尚不清楚。为了填补这一空白，2014 年 9 月至 11 月在埃塞俄比亚首都亚的斯亚贝巴的贫民窟中开展了一项基于社区的横断面研究。数据收集采用经过预测试的结构化问卷和观察检查表。采用 95%置信区间（CI）的多变量逻辑回归进行数据分析。只有 4.4%的家庭在厕所内或附近有洗手设施，并可获得肥皂和水。在五个推荐时间点用肥皂洗手的平均流行率为 19.8%。四分之一（24.8%）的照顾者在给孩子喂食前、23.8%在准备食物前以及 17.1%在便后用肥皂洗手。预防急性腹泻最重要的推荐时间是在准备食物之前（调整后的优势比（AOR）0.2；95%CI 0.1-0.7）和便后（AOR 0.3；95%CI 0.1-0.9）。家庭人口规模为 6 人或以上（AOR 2.3；95%CI 1.4-3.9）和家庭月收入低（AOR 2.4；95%CI 1.4-4.0）与急性腹泻显著相关。在五个推荐时间点促进用肥皂洗手并倡导，特别是在准备食物和便后，以及针对贫困家庭实施社会经济发展计划，对于提高用肥皂洗手的流行率和预防亚的斯亚贝巴贫民窟的急性腹泻至关重要。
