1International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh.
2The Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, Pennsylvania.
Am J Trop Med Hyg. 2021 Jan 18;104(3):874-883. doi: 10.4269/ajtmh.20-0755.
In low- and middle-income countries (LMICs), hand sanitizer may be a convenient alternative to soap and water to increase hand hygiene practices. We explored perceptions, acceptability, and use of hand sanitizer in rural Bangladesh. We enrolled 120 households from three rural villages. Promoters distributed free alcohol-based hand sanitizer, installed handwashing stations (bucket with tap, stand, basin, and bottle for soapy water), and conducted household visits and community meetings. During Phase 1, promoters recommended handwashing with soap or soapy water, or hand sanitizer after defecation, after cleaning a child's anus/feces, and before food preparation. In Phase 2, they recommended separate key times for hand sanitizer: before touching a child ≤ 6 months and after returning home. Three to 4 months after each intervention phase, we conducted a survey, in-depth interviews, and group discussions with child caregivers and male household members. After Phase 1, 82/89 (92%) households reported handwashing with soap after defecation versus 38 (43%) reported hand sanitizer use. Participants thought soap and water removed dirt from their hands, whereas hand sanitizer killed germs. In Phase 2, 76/87 (87%) reported using hand sanitizer after returning home and 71/87 (82%) before touching a child ≤ 6 months. Qualitative study participants reported that Phase 2-recommended times for hand sanitizer use were acceptable, but handwashing with soap was preferred over hand sanitizer when there was uncertainty over choosing between the two. Hand sanitizer use was liked by household members and has potential for use in LMICs, including during the coronavirus pandemic.
在中低收入国家（LMICs），用酒精基洗手液代替肥皂和水可能是一种增加手部卫生习惯的便捷选择。我们探索了孟加拉国农村地区对手部消毒剂的看法、可接受性和使用情况。我们从三个农村村庄招募了 120 户家庭。推广人员分发免费的酒精基手部消毒剂，安装洗手站（带龙头的水桶、支架、盆和装肥皂液的瓶子），并进行家访和社区会议。在第一阶段，推广人员建议在排便后、清洁儿童肛门/粪便后、准备食物前使用肥皂或肥皂水洗手，或使用手部消毒剂。在第二阶段，他们建议在接触 6 个月以下的儿童前和回家后分别使用手部消毒剂。在每一干预阶段结束后 3 到 4 个月，我们对儿童照顾者和男性家庭成员进行了调查、深入访谈和小组讨论。在第一阶段之后，89 户家庭中有 82 户（92%）报告在排便后使用肥皂洗手，而 38 户（43%）报告使用手部消毒剂。参与者认为肥皂和水可以去除手上的污垢，而手部消毒剂可以杀死细菌。在第二阶段，87 户中有 76 户（87%）报告回家后使用手部消毒剂，87 户中有 71 户（82%）报告在接触 6 个月以下的儿童前使用手部消毒剂。定性研究参与者报告说，第二阶段推荐的手部消毒剂使用时间是可以接受的，但当在两者之间选择存在不确定性时，更喜欢用肥皂洗手而不是用手部消毒剂。手部消毒剂受到家庭成员的欢迎，在包括冠状病毒大流行在内的 LMICs 中有使用潜力。
