The DOI matches its Crossref record; 78 of the 83 references it cites were found in a registry or an index; 28 of the 104 sources its claims cite were checked for support.
Hygiene: new hopes, new horizons
Open accessAbstract
Review on the public health importance of hygiene and behaviour change in low- and middle-income settings.
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Claims the paper makes
43 No full text of the sources · 28 No basis given · 22 Own interpretation · 14 Partly supported · 11 Supported · 11 Sources not found · 5 Own result · 2 Not checked yet · 2 Own method · 1 Supported so far · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Several trials have assessed the effect of promoting exclusive breastfeeding on food-borne infections, with equivocal results.28, 29”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Partly supportedcites [28] Bolam, 1998, The effects of postnatal health education for mothers on infant care and family planning practices in Nepal: a randomised controlled trial, BMJ sourceExperimental — accuracy not yet measured
The Protocol says this randomised trial promoted exclusive breastfeeding, and the Abstract reports no significant difference in infant-feeding practices. But the Outcome measures section lists mothers’ knowledge of diarrhoea management, not infants’ food-borne infections; the trial therefore does not establish an equivocal effect on those infections. Page numbers are unavailable in our copy. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [29] Jakobsen, 2008, Promotion of exclusive breastfeeding is not likely to be cost effective in West Africa. A randomized intervention study from Guinea-Bissau, Acta Paediatr source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Handwashing can also reduce other infections; one review suggested it could reduce respiratory infection by 16%,13”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Supportedcites [13] Rabie, 2006, Handwashing and risk of respiratory infections: a quantitative systematic review, Trop Med Int Health source
The Abstract reports that pooling seven homogeneous studies implied hand cleansing could cut respiratory infection risk by 16% (95% CI 11–21%). The Discussion likewise says the review's results suggest a reduction of about 16%. (LLM, conf=0.95)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Policy makers are also realising that the health benefits of increased investment in water and sanitation infrastructure are largely delivered through improvements in personal and domestic hygiene.2”
§ Hygiene: new hopes, new horizons > Introduction
What the sources say
- Partly supportedcites [2] Cairncross, 2006, Water supply, sanitation and hygiene promotion sourceExperimental — accuracy not yet measured
The Epidemiological Questions and Problems section says water supplies are likely to reduce diarrheal disease when they change hygiene behavior, supporting the water-supply part. But the Interactions with Water Supply and Sanitation section treats sanitation and hygiene promotion as having independent, additive effects, not as benefits largely delivered through hygiene improvements. The Policy Implications section does not establish that policymakers are increasingly accepting the claimed view. (LLM, conf=0.85)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a motorway service station in the south of England, just 65% of women and 31% of men washed their hands with soap after using the toilet facilities,62”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Partly supportedcites [62] Judah, 2009, Experimental pretesting of hand-washing interventions in a natural setting, Am J Public Health sourceExperimental — accuracy not yet measured
The Results report blank-control soap-use ratios of 0.651 for women and 0.317 for men, close to the cited 65% and 31%. The Methods locate the service station in England but do not specify the south; they also describe the figures as ratios of soap-dispenser uses to restroom entries, rather than directly observed proportions of individuals washing their hands. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A review of 11 studies done in Africa, Asia, and Latin America concluded that, although there are local differences, common patterns exist.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Partly supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res sourceExperimental — accuracy not yet measured
The Discussion (‘Similarities and differences’) says that handwashing practices and their determinants differed between countries, but that the findings were strikingly similar. The Introduction and Methods specify 13 studies across 11 countries—not 11 studies—including countries in Africa, Asia and Latin America. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Other motivations included comfort and nurturance (the desire to care for one's children).”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
The Discussion (‘Implications of the findings’) explicitly says that comfort and nurture may motivate handwashing. The Results (‘Handwashing: why?’) illustrate nurture as caring for children, including a mother who says she washes her hands to protect them. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Planned handwashing, with the aim of preventing disease, took place rarely.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
In Results > Handwashing: why? (page unavailable), the review says the perceived benefits of preventing child disease were probably too tenuous to prompt mothers to make conscious plans to wash with soap consistently. The Abstract also says fear of disease generally did not motivate handwashing, apart from temporary responses to epidemics. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A survey by Judah and co-workers64 reported that 28% of commuters in five UK cities had bacteria of faecal origin on their hands.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [64] Judah, 2009, Dirty hands: bacteria of faecal origin on commuters' hands, Epidemiol Infect source
The Abstract states that the study sampled commuters in five UK cities and found bacteria of faecal origin on the hands of 28% of 404 people. The Results report 111 of 404 samples positive (27.5%), consistent with the rounded figure in the claim. (LLM, conf=0.95)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“For example, when local social norms are the source of poor handwashing habits people commonly practise what they perceive everyone else to be doing, which reinforces the norm of not using soap.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
In Results, under “Affiliation,” the paper says that doing what others are perceived to do motivates handwashing behaviour. It adds that handwashing with soap is rare in most investigated communities, so conformity to local norms works against it. The Results section on the environment likewise describes perceived norms about the rarity of handwashing as a deterrent. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Three kinds of hygiene behaviour were identified: habitual, motivated, and planned.56”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
The Results section (‘Handwashing: why?’) explicitly classes explanations of handwashing behaviour as habitual, motivated, or planned. The Methods section also identifies these as three types of behaviour produced by distinct but interacting causes. (LLM, conf=0.95)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
- It may state two separate claims as one. 45
- Probably not a substantial claim. 28
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Handwashing also reduces neonatal mortality,15 trachoma,16 and parasitic worm infections.17”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Partly supportedcites [15] Rhee, 2008, Maternal and birth attendant hand washing and neonatal mortality in southern Nepal, Arch Pediatr Adolesc Med sourceExperimental — accuracy not yet measured
The Results and Discussion report significantly lower neonatal mortality associated with maternal and birth-attendant handwashing in southern Nepal. The source does not establish that handwashing caused the reduction; the Discussion acknowledges possible residual confounding. Trachoma and parasitic worm infections have separate citations in the citing sentence and are not attributed to this source. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [16] Emerson, 2000, A review of the evidence for the ‘F’ and ‘E’ components of the SAFE strategy for trachoma control, Trop Med Int Health source
- Not checked — no full text of the sourcecites [17] Fung, 2009, Ascariasis and handwashing, Trans RSoc Trop Med Hyg source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Handwashing with soap mitigated the severe acute respiratory syndrome epidemic22 and is one of the key practices recommended to counter possible influenza pandemics.23”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Partly supportedcites [22] Fung, 2006, Effectiveness of handwashing in preventing SARS: a review, Trop Med Int Health sourceExperimental — accuracy not yet measured
The Results report that handwashing was associated with reduced SARS infection in nine of ten studies' univariate analyses. But the Discussion says the evidence that handwashing was effective is suggestive, not conclusive; it does not establish that washing with soap mitigated the epidemic. The influenza-pandemic recommendation carries a separate citation (23), so it is not attributed to this paper. (LLM, conf=0.88)
- Partly supportedcites [23] Jefferson, 2008, Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review, BMJ sourceExperimental — accuracy not yet measured
The Results report that washing hands more than 10 times daily was associated with lower odds of SARS in six case-control studies. Those SARS findings do not specify soap, and the paper describes the evidence as suggesting effectiveness rather than establishing that handwashing mitigated the epidemic. The influenza-pandemic recommendation carries a separate citation in the citing sentence. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Lack of water and a perception that soap is too expensive for handwashing could also constrain handwashing (though this might be post-rationalisation because one review suggested that soap was present in 97% of all households in a review, but it was used mainly for clothes, body, and dish washing).56”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Partly supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res sourceExperimental — accuracy not yet measured
The Results (‘The environment’; page unavailable) describe water access and soap cost as possible constraints, and report soap in at least 95% of households in studies that recorded it—not 97% of all households. The paper mentions laundry soap and questions the reliability of self-reported reasons for handwashing, but the cited passages do not establish that soap was used mainly for clothes, body and dish washing. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Mothers did not find the threat of diarrhoeal disease particularly relevant and found the connection between handwashing and possible diarrhoea in children tenuous.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
In Results > Handwashing: why?, the paper says mothers did not see diarrhoea as a threat relevant to their own children and describes the chain linking handwashing to preventing child diarrhoea as too tenuous to motivate routine handwashing. The claim paraphrases that account. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Mothers did, however, plan to teach their children good manners, and they also planned to economise by ensuring that soap was not wasted.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
The Results (‘Handwashing: why?’, page not available) say that some mothers planned to teach children good manners through handwashing with soap. The Results (‘The environment’, page not available) describe conserving soap and keeping it out of reach to prevent waste, supporting the economising paraphrase. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Key motivations for handwashing were disgust of contamination on hands and to do what everyone else was perceived to be doing (social norms).”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
In Results (‘Handwashing: why?’), the paper identifies disgust at contamination on hands as a motivator and describes affiliation—doing what others are perceived to be doing—as an important handwashing motive. The Discussion (‘Implications of the findings’) also identifies disgust and affiliation as motivations for handwashing. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Handwashing with soap by child carers at key moments, such as after using the toilet, was rare, varying from 3% in Ghana to 42% in Kerala, India.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
The Results section, “What are current handwashing practices?”, reports directly observed handwashing with soap by child caregivers at critical moments. Table III gives after-toilet rates of 3% in Ghana and 42% in Kerala, India; those endpoints refer specifically to after-toilet handwashing, not every key moment. (LLM, conf=0.94)
- Partly supportedcites [57] Luby, 2009, Household characteristics associated with handwashing with soap in rural Bangladesh, Am J Trop Med Hyg sourceExperimental — accuracy not yet measured
The Introduction (p. 1) says handwashing with soap after fecal contact is typically below 30% in settings where diarrhea is a major cause of child mortality, and the Results (p. 3) report 18% after observed fecal contacts in rural Bangladesh. Our copy does not give the claimed 3% figure for Ghana or 42% figure for Kerala, India, so it supports the general rarity but not the stated range. (LLM, conf=0.87)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Hygiene habits were learnt at an early age, but soap use was rarely taught by parents or schools.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Supportedcites [56] Curtis, 2009, Planned, motivated and habitual hygiene behaviour: an eleven country review, Health Educ Res source
The Conclusions say handwashing habits are often established during childhood. In Results (Table IV), a respondent recalls being taught to wash with water but not soap; the section on the environment says schools rarely prioritized hygiene. Together, these passages support the distinction between learning handwashing habits early and being taught to use soap. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“data from a water-treatment and handwashing intervention in Kenya and an intensive handwashing educational programme in Chinese primary schools showed a reduction in absenteeism.77, 78”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not checked — no full text of the sourcecites [77] Bowen, 2007, A cluster-randomized controlled trial evaluating the effect of a handwashing promotion program in Chinese primary schools, Am J Trop Med Hyg source
- Supportedcites [78] O'Reilly, 2008, The impact of a school-based safe water and hygiene programme on knowledge and practices of students and their parents: Nyanza Province, western Kenya, Epidemiol Infect source
The Summary (p. 1) reports that absenteeism decreased by 35% in nine Kenyan project schools, while increasing by 5% in neighbouring comparison schools. The Discussion (p. 8) identifies the intervention as safe drinking water, handwashing facilities, and hygiene education. The Chinese programme is associated with the other citation, not attributed to this source. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, very few RCTs of hygiene promotion programmes have been undertaken in developing countries, and those that have been done have several methodological flaws.”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, no studies that we know of have quantified the risks associated with the use of cow dung for fuel or in house maintenance.”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The biological plausibility of most hygiene interventions is high (table 1);”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After the programme had run for 3 years, three-quarters of the mothers targeted had been involved with programme activities and half could cite the two main messages of the programme correctly.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Safe food handling and preparation is also important, especially for children, as is the avoidance of animal faeces and the safe storage and use of water.3”
§ Hygiene: new hopes, new horizons > Introduction
What the sources say
- Not checked — no full text of the sourcecites [3] Curtis, 2000, Domestic hygiene and diarrhoea, pinpointing the problem, Trop Med Int Health source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Face or whole-body washing are less well researched but might help to control skin infections and trachoma.18”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [18] Ngondi, 2009, Evaluation of three years of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental improvement) for trachoma control in five districts of Ethiopia hyperendemic for trachoma, Trans R Soc Trop Med Hyg source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Adequate handwashing after contact with faeces is also crucial (after one's own defecation, after handling the faeces of children, or after contact with a faeces-contaminated environment).”
§ Hygiene: new hopes, new horizons > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“These data are more readily available, but can be misleading.6”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [6] Blum, 1983, Measuring the impact of water supply and sanitation investments on diarrhoeal diseases: problems of methodology, IntJ Epidemiol source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Other diseases that can be prevented by adequate hygiene include respiratory infections, trachoma, and skin infections.”
§ Hygiene: new hopes, new horizons > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The most important ingredient still missing is the full and active engagement of the health sector in improving global hygiene.”
§ Hygiene: new hopes, new horizons > Introduction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Rests on an assumption: Too few health professionals are engaged in programmes to promote hygiene.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Evidence from all four types of source is consistent, with RCTs of handwashing interventions showing reductions in diarrhoea of around 30%, and of 43–47% if soap is used.11, 12”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [11] Curtis, 2003, Effect of washing hands with soap on diarrhoea risk in the community: a systematic review, Lancet Infect Dis source
- Not checked — no full text of the sourcecites [12] Ejemot, 2008, Hand washing for preventing diarrhoea, Cochrane Database Syst Rev source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Improved water supplies and sanitation facilities make it easier to practise hygiene, keeping children and adults safe from infection.”
§ Hygiene: new hopes, new horizons > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Improvements in hygiene, sanitation, and water can prevent several important infections, in addition to providing other benefits.”
§ Hygiene: new hopes, new horizons > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Contaminated weaning food, in particular, has been suggested as a major contributor to diarrhoea in low-income settings,26 although observational studies gave inconclusive results.24”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [26] Motarjemi, 1993, Contaminated weaning food: a major risk factor for diarrhoea and associated malnutrition, Bull World Health Organ
- Not checked — no full text of the sourcecites [24] Lanata, 2003, Studies of food hygiene and diarrhoeal disease, Int J Environ Health Res source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Among these avoidable infections prevention of diarrhoeal diseases is most important.”
§ Hygiene: new hopes, new horizons > Introduction
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although promotion of safe hygiene is the single most cost-effective means of preventing infectious disease, investment in hygiene is low both in the health and in the water and sanitation sectors.”
§ Hygiene: new hopes, new horizons > Abstract
plain- Asserted: passes — The authors put it forward as true.
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- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“For example, the masking of participants to the intervention is difficult, and as a result, mothers who are grateful for an intervention may be less likely to report disease in their children, leading to inflated effect sizes.9”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [9] Wood, 2008, Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study, BMJ source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The evidence for giving hygiene a much higher priority is strong, and, to a large extent, we already know what needs to be done.”
§ Hygiene: new hopes, new horizons > Introduction
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, these approaches depend on access to good estimates of environmental contamination, which are largely unavailable for developing countries.”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Full and active involvement of the health sector in getting safe hygiene to all homes, schools, and institutions will bring major gains to public health.”
§ Hygiene: new hopes, new horizons > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
- Rests on an assumption: Most sanitation and water supply programme implementers seek to improve hygiene alongside hardware but rarely have the resources and professional support to do this effectively.
- Rests on an assumption: Too few health professionals are engaged in programmes to promote hygiene.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Other ways of preventing the faecal–oral transmission of infections include keeping water, foods, and surfaces free of faecal contamination and preventing carriage by flies.”
§ Hygiene: new hopes, new horizons > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Other obstacles include the absence of hard surfaces that can easily be kept clean, unavailability of cleaning materials such as soap and surface cleansers, and limited access to hygiene aids, such as potties or nappies.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Household surfaces seem to play a major part in disease transmission, although most evidence is from developed countries,39, 40, 41”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [39] Barker, 2000, Survival of Salmonella in bathrooms and toilets following salmonellosis, J Appl Microbiol source
- Not checked — no full text of the sourcecites [40] Cozad, 2003, Disinfection and the prevention of infectious disease, Am J Infect Control source
- Not checked — no full text of the sourcecites [41] Cogan, 2002, Achieving hygiene in the domestic kitchen: the effectiveness of commonly used cleaning procedures, J Appl Microbiol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“as could information suggesting that handwashing with soap is a desirable social norm where it is not one.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“A national handwash programme in Ghana that used disgust and nurture to motivate handwashing increased self-reported handwashing before eating by 41% and after defecation by 13%.51”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not matchedcites [51] Scott, 2007, Marketing hygiene behaviours: the impact of different communications channels on reported handwashing behaviour of women in Ghana, Health Educ Res
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The weight of evidence suggests that hygiene promotion is effective in reducing disease, can be promoted both directly and by mass media programmes with relatively low expenditure per person targeted,1, 51 and has few adverse effects.”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not matchedcites [1] Jamieson, 2006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [51] Scott, 2007, Marketing hygiene behaviours: the impact of different communications channels on reported handwashing behaviour of women in Ghana, Health Educ Res
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“The project increased observed handwashing with soap by mothers from 1% to 17% after using the toilet and from 13% to 31% after cleaning up a child (panel 1 ).72”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not checked — no full text of the sourcecites [72] Curtis, 2001, Evidence for behaviour change following a hygiene promotion programme in West Africa, Bull World Health Organ
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“perhaps suggesting that changing four distinct hygiene practices over a short time is unrealistic.”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although additional intervention trials using improved outcome measures are urgently needed to confirm previous findings, hygiene promotion can already be recommended for large-scale implementation.”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although an understanding of the determinants of handwashing behaviour is helpful, how such insight can be used in behaviour change programmes is not always obvious.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In some settings fly control might reduce diarrhoea risk by around 25%,46, 47, 48 and lessen the risk of trachoma.”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [46] Chavasse, 1999, Impact of fly control on childhood diarrhoea in Pakistan: community-randomised trial, Lancet source
- Not checked — no full text of the sourcecites [47] Emerson, 1999, Trachoma and fly control, J Comm Eye Health
- Not checked — no full text of the sourcecites [48] Emerson, 1999, Effect of fly control on trachoma and diarrhoea, Lancet source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Whether an intervention can be recommended for implementation depends not only on the evidence of disease reduction, but also on its scalability, acceptability, and the risk of adverse effects.50”
§ Hygiene: new hopes, new horizons > Hygiene and health: the evidence
What the sources say
- Not checked — no full text of the sourcecites [50] Ross, 2006, The weight of evidence: a method for assessing the strength of evidence on the effectiveness of HIV prevention interventions among young people, World Health Organ Tech Rep Ser
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Though changing behaviour is difficult, we know a lot more about hygiene behaviour than we did 10 years ago and promising approaches to changing hygiene on a large scale are emerging.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For behaviour to change one, or several, of these factors will have to be addressed, but to do so will require a better understanding of them.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Environmental changes that make handwashing easier and cheaper, such as the introduction of simple water-saving technologies (eg, so-called tippy taps), could be helpful (although how their use could become widespread is unclear),”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Efforts are continuing to identify indicators of hygiene practice that are both valid and simple to collect.53, 54, 55”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not checked — no full text of the sourcecites [53] Biran, 2008, Comparing the performance of indicators of hand-washing practices in rural Indian households, Trop Med Int Health source
- Not checked — no full text of the sourcecites [54] Luby, 2008, Associations among handwashing indicators, wealth, and symptoms of childhood respiratory illness in urban Bangladesh, Trop Med Int Health source
- Not checked — no full text of the sourcecites [55] Webb, 2006, A simple index to measure hygiene behaviours, Int J Epidemiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Aunger and colleagues68 observed that habit was the most powerful determinant of handwashing in Kenya, followed by several motives including disgust, and social norms, and cognitive plans to save money.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not checked — no full text of the sourcecites [68] Aunger, 2010, Three kinds of psychological determinants for hand-washing behaviour in Kenya, Soc Sci Med source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“the low-income sections of society, which are at greatest risk of death from diarrhoeal disease and have fewer resources to commit to hygiene.80”
§ Hygiene: new hopes, new horizons > Policy issues—what the health sector needs to do
What the sources say
- Not checked — no full text of the sourcecites [80] Schmidt, 2009, Determinants of handwashing practices in Kenya: the role of media exposure, poverty and infrastructure, Trop Med Int Health source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Even when we are successful in changing hygiene behaviours we still do not know how persistent such changes are,11, 12 or the sort of investment that is needed to maintain the gains in a given population.”
§ Hygiene: new hopes, new horizons > Policy issues—what the health sector needs to do
What the sources say
- Not checked — no full text of the sourcecites [11] Curtis, 2003, Effect of washing hands with soap on diarrhoea risk in the community: a systematic review, Lancet Infect Dis source
- Not checked — no full text of the sourcecites [12] Ejemot, 2008, Hand washing for preventing diarrhoea, Cochrane Database Syst Rev source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because there are many different ways to promote hygiene, having more diverse and properly evaluated programmes will build a body of knowledge as to what works best in changing these persistent habitual behaviours.”
§ Hygiene: new hopes, new horizons > Hygiene: a roadmap to success
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If these programmes are successful in leading the members of all societies to adopt hygienic habits as a matter of course, then hygiene will be able to take its rightful place as one of the foundation stones of global health.”
§ Hygiene: new hopes, new horizons > Hygiene: a roadmap to success
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“The innovative method of community health clubs used in Zimbabwe significantly changed hygiene behaviour and built rural demand for sanitation.76”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not checked — no full text of the sourcecites [76] Waterkeyn, 2005, Creating demand for sanitation and hygiene through Community Health Clubs: a cost-effective intervention in two districts in Zimbabwe, Soc Sci Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We searched the reference lists of relevant articles and contacted authors and experts for further identification of articles.”
§ Hygiene: new hopes, new horizons > Search strategy and selection criteria
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We searched Medline, from 1970 to 2009, regardless of language, using the search terms “[diarrh(o)ea AND hygiene]”, “[respiratory AND hygiene]”, “[food AND hygiene]”, “[pneumonia AND hygiene]”, “[stool AND disposal]”, “[waste AND hygiene]”, and “[animal faeces AND diarrh(o)ea]”.”
§ Hygiene: new hopes, new horizons > Search strategy and selection criteria
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Procter & Gamble and its Safeguard brand has reached 35 million children with one-on-one, school-based handwashing education and is planning to reach 100 million more by 2012.8”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not matchedcites [8] Kaufman, 1997, Socioeconomic status and health in blacks and whites: the problem of residual confounding and the resiliency of race, Epidemiology
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 35- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“In 1 year in Makoni District, 1244 health sessions were held by 14 trainers, costing an average of US$0·21 per beneficiary and involving 11 450 club members.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not checked — no full text of the sourcecites [76] Waterkeyn, 2005, Creating demand for sanitation and hygiene through Community Health Clubs: a cost-effective intervention in two districts in Zimbabwe, Soc Sci Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If we cannot accurately measure changes in hygiene behaviour we cannot measure the effectiveness of interventions in trials or evaluate the delivery of behaviour change in programmes.”
§ Hygiene: new hopes, new horizons > Policy issues—what the health sector needs to do
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Other promising approaches, such as trying to establish hygiene habits in schools, are thought to be effective.”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Once hygiene is established, improvements in behaviours will be truly sustainable.”
§ Hygiene: new hopes, new horizons > Policy issues—what the health sector needs to do
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“If promoting hygiene in emerging markets makes good business sense to private companies, because they can improve sales and enhance their reputations, this could lead to sustained long-term improvements in public health, as it has in developed countries.9”
§ Hygiene: new hopes, new horizons > Hygiene behaviour
What the sources say
- Not checked — no full text of the sourcecites [9] Wood, 2008, Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study, BMJ source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Food hygiene has the best claim to be tackled first, but all of the hygiene practices we have discussed have been neglected relative to the efforts for malaria or HIV research.”
§ Hygiene: new hopes, new horizons > Hygiene: a roadmap to success
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“If hygiene promotion is truly the most cost-effective intervention for preventing disease in developing countries,1”
§ Hygiene: new hopes, new horizons > Policy issues—what the health sector needs to do
What the sources say
- Not matchedcites [1] Jamieson, 2006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper may give no reason why it holds.
- Not matched
In the paper
“simple questionnaire surveys give overestimates of behaviours such as handwashing, whereas direct observation is cumbersome and intrusive, and technological fixes, such as Smart Soap (containing accelerometers that record usage) have drawbacks too.14”
§ Hygiene: new hopes, new horizons > Policy issues—what the health sector needs to do
What the sources say
- Not checked — no full text of the sourcecites [14] Luby, 2005, Effect of handwashing on child health: a randomised controlled trial, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Though the evidence base is far from complete, the information we do have strongly suggests a need to improve handwashing behaviour, stool disposal practices, and food hygiene in particular when weaning.”
§ Hygiene: new hopes, new horizons > Hygiene: a roadmap to success
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The authors state this as an assumption.
The handwashing data from the 11-country article and the Bangladesh survey are a good guide to handwashing with soap at key moments in developing countries.
“If these figures are a good guide, less than one in six children in developing countries is protected from disease by handwashing with soap at key moments.”
The paper relies on this without support.
Most sanitation and water supply programme implementers seek to improve hygiene alongside hardware but rarely have the resources and professional support to do this effectively.
“Although most sanitation and water supply programme implementers seek to improve hygiene alongside hardware, they rarely have the resources and professional support needed to do this effectively.”
The paper relies on this without support.
Too few health professionals are engaged in programmes to promote hygiene.
“Health professionals recognise the need for better hygiene, but too few are actually engaged in programmes to promote it.”
The authors state this as an assumption.
The true effect of hygiene promotion on disease in low-income settings may be smaller than studies suggest.
“Even if the true effect on disease in low-income settings is smaller than studies suggest, hygiene improvements will likely have an effect on disease control at large scale.”
The paper relies on this without support.
The standard approach to hygiene promotion has until recently been educational.
“The standard approach to hygiene promotion, whether through schools, clinics, or health outreach programmes, has, until recently, been educational.”
The paper relies on this without support.
Knowledge about possible long-term health effects does not necessarily translate into practice.
“However, knowledge about possible long-term health effects does not necessarily translate into practice.”
The paper relies on this without support.
PHAST has become the predominant model among non-government organisations in the past two decades.
“In the past two decades an approach known as PHAST (participatory hygiene and sanitation transformation) has become the predominant model among non-government organisations.”
The paper relies on this without support.
PHAST is mostly an educational approach, heavily reliant on trained facilitators, and difficult to implement on a large scale.
“Although it is an imaginative attempt to involve communities in solving their own hygiene problems, PHAST is mostly an educational approach, is heavily reliant on the skills of trained facilitators, and is difficult to implement on a large scale.”
The paper relies on this without support.
There are no rigorously collected data to support the effectiveness of PHAST programmes.
“There are no rigorously collected data to support the effectiveness of PHAST programmes”
The paper relies on this without support.
Some evidence from Tanzania and Uganda indicates that PHAST has limited effect on hygiene behaviour.
“some evidence from Tanzania and Uganda indicates that the approach has limited effect on hygiene behaviour.”
The paper relies on this without support.
Evidence of effect of school hygiene programmes is scarce.
“Although evidence of effect is scarce”
The paper relies on this without support.
The Global Public–Private Partnership for Handwashing with Soap has been building coalitions and national programmes in over 17 developing countries.
“the Global Public–Private Partnership for Handwashing with Soap (PPP-HW) has been building coalitions and national programmes in over 17 developing countries.”
The paper relies on this without support.
Good preliminary results were achieved after 1 year of programme activities in Ghana.
“Good preliminary results were achieved after 1 year of programme activities in Ghana”
The paper relies on this without support.
The PPP-HW model is convincing and innovative enough to have attracted substantial funds.
“the model is convincing and innovative enough to have attracted substantial funds”
The paper relies on this without support.
Questions about the effectiveness of PPP-HW remain.
“but questions about effectiveness remain.”
The paper relies on this without support.
In Ghana, Peru, and Senegal public health authorities and soap companies were not always easy bedfellows.
“In Ghana, Peru, and Senegal public health authorities and soap companies were not always easy bedfellows”
The paper relies on this without support.
National partnerships can be hard to sustain for longer than just one campaign.
“national partnerships can be hard to sustain for longer than just one campaign.”
The paper relies on this without support.
Gathering rigorous public domain evidence about the effectiveness of large-scale handwashing promotion efforts is proving challenging.
“gathering such data is proving challenging, especially when interventions cannot be centrally controlled because they depend on the goodwill of various partners.”
The paper relies on this without support.
Unilever has made handwashing part of the social mission of the Lifebuoy brand and has pledged to bring handwashing to one billion people by 2012.
“Unilever, for example, has made handwashing part of the social mission of the Lifebuoy brand and has pledged to bring handwashing to one billion people by 2012.”
The paper relies on this without support.
Local soap companies such as GeTrade in Ghana are also contributing their efforts.
“Local soap companies such as GeTrade in Ghana are also contributing their efforts.”
The paper relies on this without support.
Far more is known about hygiene now than a decade ago.
“Far more is known about hygiene now than a decade ago.”
The paper relies on this without support.
Hygiene features seldom in international public health efforts.
“hygiene features so seldom in international public health efforts.”
The paper relies on this without support.
Health workers will continue to use outdated methods and health education approaches that are demotivating because they are ineffective.
“otherwise they will continue to use outdated methods and health education approaches that are demotivating because they are ineffective.”
The paper relies on this without support.
We know enough to act now, but gaps in our knowledge exist.
“although we know enough to act now, gaps in our knowledge exist.”
The paper relies on this without support.
Investment in hygiene still remains low.
“although investment still remains low”
The paper relies on this without support.
The topic of hygiene is moving up the political agenda.
“the topic of hygiene is moving up the political agenda.”
The paper relies on this without support.
Inspired advocacy events, such as the Global Handwashing Day organised by the Global PPP-HW, have enhanced the global profile of hygiene.
“Inspired advocacy events, such as the Global Handwashing Day organised by the Global PPP-HW, have enhanced the global profile of hygiene.”
The paper relies on this without support.
Creating the framework for policy building is challenging given competition for attention in the relevant ministries, their limited human and logistic resources, and shortage of skills.
“Creating this framework is challenging given competition for attention in the relevant ministries, their limited human and logistic resources, and shortage of skills.”
The paper relies on this without support.
These problems are often worst in the remote and poverty-stricken areas that would benefit most from improved hygiene.
“These problems are often worst in the remote and poverty-stricken areas that would benefit most from improved hygiene.”
The paper relies on this without support.
Training in up-to-date methods of communication is lacking at all levels in health ministries.
“Training in up-to-date methods of communication is lacking at all levels in health ministries.”
The paper relies on this without support.
Funding such skills development has not been a priority for donors in recent years.
“funding such skills development has, unfortunately, not been a priority for donors in recent years.”
The paper relies on this without support.
Marketing expertise from the private sector has been helping to fill the skills gap.
“Marketing expertise from the private sector has been helping to fill the skills gap”
The paper relies on this without support.
The interface between programmes and health research is problematic.
“The interface between programmes and health research is also problematic”
The paper relies on this without support.
Local universities are the obvious institutions for designing and evaluating hygiene promotion programmes, but very few have that capacity at present.
“Local universities are the obvious institutions for designing and evaluating hygiene promotion programmes, but very few have that capacity at present.”
The paper relies on this without support.
Large-scale engineering programmes are rarely equipped to handle the behavioural side of development.
“large-scale engineering programmes are rarely equipped to handle what they call the software (ie, the behavioural) side of development.”
The paper relies on this without support.
Decentralised authorities and non-government organisations are often willing to implement hygiene promotion, but rarely have the specific expertise or capacity to develop the approaches themselves.
“Such agencies are often willing to implement hygiene promotion, but rarely have the specific expertise or capacity to develop the approaches themselves.”
The paper relies on this without support.
Simple technologies, such as water-saving taps, nappies, potties, and child-friendly toilets, can help families to live more hygienically.
“simple technologies, such as water-saving taps, nappies, potties, and child-friendly toilets, can help families to live more hygienically”
The paper relies on this without support.
Little effort has been made to develop and market hygiene-helping products that are appropriate for the consumers with low income.
“little effort has been made to develop and market hygiene-helping products that are appropriate for the consumers with low income.”
The paper relies on this without support.
All of the hygiene practices we have discussed have been neglected relative to the efforts for malaria or HIV research.
“all of the hygiene practices we have discussed have been neglected relative to the efforts for malaria or HIV research.”
The paper relies on this without support.
There is no evidence to indicate whether the practice of using animal dung to smooth floors and walls is injurious to family health.
“there is no evidence to indicate whether the practice of using animal dung to smooth floors and walls (common in Asia) is injurious to family health.”
The paper relies on this without support.
Most schools in developing countries still do not have sanitation and hygiene facilities.
“most schools in developing countries still do not have sanitation and hygiene facilities”
The paper relies on this without support.
Health centres, hospitals, maternity facilities, workplaces, and public institutions still cannot offer water and soap to their users.
“health centres, hospitals, maternity facilities, workplaces, and public institutions still cannot offer water and soap to their users.”
The paper relies on this without support.
Birth attendants and outreach workers are not always trained to wash hands with soap and do not systematically promote handwashing and hygiene to mothers.
“birth attendants and outreach workers are not always trained to wash hands with soap and do not systematically promote handwashing and hygiene to mothers.”
The paper relies on this without support.
In the next 5–10 years we have a window of opportunity to develop the high impact programmes which will bring about mass scale changes.
“In the next 5–10 years we have a window of opportunity to develop the high impact programmes which will bring about mass scale changes.”
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“There is little proof that such educational approaches are eff ective, either in developing, 73, 74 or developed countries.”
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Self-citation
Metadata
- Authors
- Curtis, V., Schmidt, W., Luby, S., Florez, R., Touré, O., & Biran, A.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- International Centre for Diarrhoeal Disease Research (BD)
- Ministère de la Santé et de l'Hygiène Publique (ML)
- Corresponding author
- Curtis, Val
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2011-04
- Volume
- 11
- Issue
- 4
- Pages
- 312-321
- ISSN
- 1473-3099 (ISSN-L)
- PMC
- PMC7106354
- OpenAlex
- W2166713712
- Cited by
- 228
- References
- 83
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 6 · 2023: 10 · 2022: 13 · 2021: 20 · 2020: 28 · 2019: 13 · 2018: 10 · 2017: 18 · 2016: 15 · 2015: 15 · 2014: 16 · 2013: 24 · 2012: 14
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Lancet Infectious Diseases (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Safety and Hygiene
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- hygiene promotion, hand washing, hygiene behaviour change, food hygiene, social norms, water and sanitation, infectious disease prevention, developing countries
- MeSH terms
- Communicable Disease Control, Communicable Diseases, Humans, Hygiene, Public Health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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