News
HST Collects relevant news from a variety of sources, for your convenience. Select a story from below, or use our search feature to find stories of interest.

Handwashing programmes could be intervention of choice for diarrhoeal diseases
Abergavenny Roger Dobson
2003-05-15

A new systematic review that set out to determine the impact of washing hands with soap in the community worldwide concludes that handwashing could reduce the risk of diarrhoea by up to 47%. On current evidence, washing hands with soap can reduce the risk of diarrhoeal diseases by 42-47% and interventions to promote hand washing might save a million lives. In the absence of adequate mortality studies, we extrapolate the potential number of diarrhoea deaths that could be averted by hand washing at about a million, wrote the authors (Lancet Infectious Diseases 2003;3:275-81). Diarrhoeal diseases are among the top three killers of children, and the authors say that the most recent published estimate of the total annual death rate from diarrhoeal diseases is 2.2 million. The authors say that, although there is much discussion about how to improve handwashing habits in healthcare settings, the importance of handwashing in homes, particularly in developing countries, gets scant attention. Rigorous intervention trials are needed to explore the impact of hand washing on diarrhoea and other infections, in a variety of settings. Basic work is still needed to clarify when hands should be washed, how often, by whom, and in what manner. Simple indicators of hand washing compliance need to be developed and validated, they say. (Source: Abergavenny Roger Dobson, News Extra: BMJ 2003;326:1004 )

Handwashing could prevent more than one million deaths a year from diarrhoeal diseases. A new systematic review that set out to determine the impact of washing hands with soap in the community worldwide concludes that handwashing could reduce the risk of diarrhoea by up to 47%. 

On current evidence, washing hands with soap can reduce the risk of diarrhoeal diseases by 42-47% and interventions to promote hand washing might save a million lives. In the absence of adequate mortality studies, we extrapolate the potential number of diarrhoea deaths that could be averted by hand washing at about a million, wrote the authors (Lancet Infectious Diseases 2003;3:275-81).

The authors, from the London School of Hygiene and Tropical Medicine, add, Although more and more rigorous intervention trials of the health impact of hand washing are badly needed, current evidence shows a clear and consistent pattern. If hand washing with soap could save over a million lives, if rates of hand washing are currently very low, and if carefully designed hand washing promotion programmes can be effective and cost-effective, then hand washing promotion may become an intervention of choice. 

Diarrhoeal diseases are among the top three killers of children, and the authors say that the most recent published estimate of the total annual death rate from diarrhoeal diseases is 2.2 million. 

The authors of the review set out to identify all studies published in English up to the end of 2002 that related handwashing to the risk of infectious intestinal or diarrhoeal diseases in the community. They selected 17 (of the 38 papers with relevant content) for inclusion in the meta-analysis and estimated the effect of handwashing on mortality on the basis of published figures. 

The authors say that, although there is much discussion about how to improve handwashing habits in healthcare settings, the importance of handwashing in homes, particularly in developing countries, gets scant attention.

Interest in the diarrhoeal diseases peaked in the 1980s with efforts to promote oral rehydration and improved water supply. Today, they are ranked third as cause of death and second as cause of healthy life years lost due to premature mortality and disability. However, whereas major new initiatives to combat malaria, HIV, and tuberculosis have been announced, interest in research and intervention in the diarrhoeal diseases has waned, they say in their article. 

Although their evidence suggests that the promotion of handwashing with soap in homes in developing countries should become a public health intervention of choice, the authors say much work remains to be done. 

Rigorous intervention trials are needed to explore the impact of hand washing on diarrhoea and other infections, in a variety of settings. Basic work is still needed to clarify when hands should be washed, how often, by whom, and in what manner. Simple indicators of hand washing compliance need to be developed and validated, they say. (Source: News Extra: BMJ 2003;326:1004)

Keywords	This Item is associated with the Following Keywords: .
You Can Comment on this Item, or View other people's Comments
Easy Print  Email to a friend

	Related News
	Poor sanitation threatens public health - WHO (2008-03-25) Between Diarrhoeal Diseases and HIV/AIDS Debates in South Africa - (2001-10-25) Information on polio (2006-06-30) Intravenous equipment caused outbreak (2005-07-08) Clean drinking water for homes in Africa and other less developed countries (2005-09-02)

	Related Publications
	Oral Rehydration Therapy Corners and the Management of Diarrhoeal illness in children (2000-05-02) Department of Health Annual Report 2000/2001 (2001-11-15) Nutrition (2000-04-17) Providing Antiretroviral Treatment in Southern Africa - A Literature Review (2004-05-14) The Demographic Impact of HIV/AIDS in South Africa - National Indicators for 2004 (2005-01-27)

	Related Health Statistics
	Diarrhoea incidence under 5 years (per 1 000) (0000-00-00) Cataract surgery rate (surgeries per million uninsured population) (2006-06-07) HIV prevalence (%) (antenatal) (2004-10-04) Neonatal death rate (NNDR) (deaths <28 days old per 1 000 live births) (0000-00-00) Perinatal mortality rate (deaths <8 days old per 1 000 total births) (0000-00-00)

	Related Events
	International Conference on HIV/AIDS, Food and Nutrition Security (2005-04-14) Reforming Healthcare - Is implementing social health insurance the answer? (2005-03-14) Symposium: The threat of emerging & re-emerging diseases To Global Health Security (2002-11-04) The Joint Congress of the Infectious Diseases & Sexually Transmitted Diseases Societies of Southern (2001-12-02) 11th ISfTeH International Conference (2006-11-26)

	Related links
	Environmental Health Project WHO Weekly Epidemiological Record South African Demographic and Health Survey 1998. Preliminary Report MSF Campaign for Access to Essential Medicines Better Births Initiative

	Related Content
	HST Conference 2007: Accommodation (2007-08-31) HealthLink Bulletin - Terms of Use (2007-03-23) 2006 South African Health Review Authors’ Guidelines (2004-12-06) SAHR Referencing Style (2004-12-06) The Southern African Development Community Project on Sexually Transmitted Infections in High Transmission Areas (2005-09-21)