Impact of a School-Based Hygiene Promotion and Sanitation Intervention on Pupil Hand Contamination in Western Kenya: A Cluster Randomized Trial

Greene, Leslie E.; Freeman, Matthew C.; Akoko, Daniel; Saboori, Shadi; Moe, Christine; Rheingans, Richard

doi:10.4269/ajtmh.2012.11-0633

Cited by 123Child Nutrition and Water AccessSchool Health and Nursing EducationFood Safety and Hygiene

Impact of a School-Based Hygiene Promotion and Sanitation Intervention on Pupil Hand Contamination in Western Kenya: A Cluster Randomized Trial

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Greene, Leslie E., Freeman, Matthew C., Akoko, Daniel, Saboori, Shadi, Moe, Christine, Rheingans, Richard·2012·The American Society of Tropical Medicine and Hygiene

DOI 10.4269/ajtmh.2012.11-0633PMC PMC3435337

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Abstract

Handwashing with soap effectively reduces exposure to diarrhea-causing pathogens. Interventions to improve hygiene and sanitation conditions in schools within low-income countries have gained increased attention; however, their impact on schoolchildren's exposure to fecal pathogens has not been established. Our trial examined whether a school-based water, sanitation, and hygiene intervention reduced Escherichia coli contamination on pupils' hands in western Kenya. A hygiene promotion and water treatment intervention did not reduce risk of E. coli presence (relative risk [RR] = 0.92, 95% confidence interval [CI] = 0.54–1.56); the addition of new latrines to intervention schools significantly increased risk among girls (RR = 2.63, 95% CI = 1.29–5.34), with a non-significant increase among boys (RR = 1.36, 95% CI = 0.74–2.49). Efforts to increase usage of school latrines by constructing new facilities may pose a risk to children in the absence of sufficient hygiene behavior change, daily provision of soap and water, and anal cleansing materials.

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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 [25]

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Authors: Greene, L. E., Freeman, M. C., Akoko, D., Saboori, S., Moe, C., & Rheingans, R.
Affiliations: Emory University (US)
Corresponding author: Greene, Leslie E.
ORCID: Freeman, Matthew C.
Moe, Christine
Rheingans, Richard
Venue: The American Society of Tropical Medicine and Hygiene
Publisher: American Society of Tropical Medicine and Hygiene
Published: 2012-09-05
Volume: 87
Issue: 3
Pages: 385-393
ISSN: 0002-9637 (ISSN-L)
1476-1645
DOI: 10.4269/ajtmh.2012.11-0633
PMC: PMC3435337
OpenAlex: W2150544519
Cited by: 123
References: 36
Citations by year: 2026: 2 · 2024: 5 · 2023: 7 · 2022: 9 · 2021: 14 · 2020: 8 · 2019: 14 · 2018: 3 · 2017: 14 · 2016: 12 · 2015: 13 · 2014: 14 · 2013: 7 · 2012: 1
FWCI: 10.46
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/2.5/ (unspecified)
Locations: American Journal of Tropical Medicine and Hygiene (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Funders: Bill and Melinda Gates Foundation
Emory University
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
Life Sciences › Agricultural and Biological Sciences › Food Science › Food Safety and Hygiene
Keywords: hand hygiene, hand contamination, Escherichia coli, school sanitation, school latrines, hygiene promotion, fecal pathogens, elementary school students, diarrhea, sex differences, Western Kenya
MeSH terms: Adolescent, Child, Diarrhea, Escherichia coli, Female, Follow-Up Studies, Hand Disinfection, Humans, Hygiene, Kenya, Male, Poverty, Risk Factors, Sanitation, Schools, Soaps, Toilet Facilities, Cluster Analysis

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Impact of a School-Based Hygiene Promotion and Sanitation Intervention on Pupil Hand Contamination in Western Kenya: A Cluster Randomized Trial

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