Impact of Regular Soap Provision to Primary Schools on Hand Washing and E. coli Hand Contamination among Pupils in Nyanza Province, Kenya: A Cluster-Randomized Trial
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We assessed whether supplying soap to primary schools on a regular basis increased pupil hand washing and decreased Escherichia coli hand contamination. Multiple rounds of structured observations of hand washing events after latrine use were conducted in 60 Kenyan schools, and hand rinse samples were collected one time in a subset of schools. The proportion of pupils observed practicing hand washing with soap (HWWS) events was significantly higher in schools that received a soap provision intervention (32%) and schools that received soap and latrine cleaning materials (38%) compared with controls (3%). Girls and boys had similar hand washing rates. There were non-significant reductions in E. coli contamination among intervention school pupils compared with controls. Removing the barrier of soap procurement can significantly increase availability of soap and hand washing among pupils; however, we discuss limitations in the enabling policy and institutional environment that may have prevented reaching desired levels of HWWS.
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Four of the 18 publications reported no evidence of reduced risk for the primary disease-related outcome measures, including soil-transmitted helminths and E. coli on pupils' hands.
“Four of the 18 publications reported no evidence of reduced risk for the primary disease-related outcome measures, including soil-transmitted helminths and E. coli on pupils’ hands [17,20,25,26].”
From Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact (2019) · cites this paper as [17]
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- Authors
- Saboori, S., Greene, L. E., Moe, C. L., Freeman, M. C., Caruso, B. A., Akoko, D., & Rheingans, R. D.
- Affiliations
- Emory University (US)
- Corresponding author
- Saboori, Shadi
- Venue
- The American Society of Tropical Medicine and Hygiene
- Published
- 2013-10-09
- Volume
- 89
- Issue
- 4
- Pages
- 698-708
- ISSN
- 0002-9637 (ISSN-L)
- 1476-1645
- PMC
- PMC3795100
- OpenAlex
- W2115375542
- Cited by
- 53
- References
- 56
- Citations by year
- 2026: 4 · 2025: 4 · 2023: 8 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 3 · 2018: 1 · 2017: 4 · 2016: 5 · 2015: 2 · 2014: 1
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Tropical Medicine and Hygiene (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- 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 › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- handwashing with soap, elementary school students, hand hygiene, latrine use, school sanitation, Nyanza Province
- MeSH terms
- Child, Escherichia coli, Female, Hand Disinfection, Health Education, Humans, Kenya, Male, School Health Services, Schools, Skin, Soaps, Time Factors, Water, Cluster Analysis, Program Development
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