Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr 1;14(4):371.
doi: 10.3390/ijerph14040371.

Hand Hygiene Intervention Strategies to Reduce Diarrhoea and Respiratory Infections among Schoolchildren in Developing Countries: A Systematic Review

Balwani Chingatichifwe Mbakaya  1 , Paul H Lee  2 , Regina L T Lee  3
Affiliations

Hand Hygiene Intervention Strategies to Reduce Diarrhoea and Respiratory Infections among Schoolchildren in Developing Countries: A Systematic Review

Balwani Chingatichifwe Mbakaya et al. Int J Environ Res Public Health. .

Abstract

Effective and appropriate hand-washing practice for schoolchildren is important in preventing infectious diseases such as diarrhoea, which is the second most common cause of death among school-age children in sub-Saharan Africa. The objective of the review was to identify hand hygiene intervention strategies to reduce infectious diseases such as diarrhoea and respiratory tract infections among schoolchildren aged 6-12 years in developing countries. Published research articles were searched from databases covering a period from as far back as the creation of the databases to November 2015. Eight randomized controlled trials (RCT/CRCT) from developing countries met the inclusion criteria. The Jadad Scale for appraising RCT/CRCT studies revealed methodological challenges in most studies, such that 75% (6/8) were rated as low-quality articles. The review found that hand hygiene can reduce the incidence of diarrhoea and respiratory conditions. Three hand hygiene intervention strategies utilized were training, funding and policy, with training and funding implemented more commonly than policy. These strategies were not only used in isolation but also in combination, and they qualified as multi-level interventions. Factors that influenced hand washing were contextual, psychosocial and technological. Findings can inform school health workers in categorizing and prioritizing activities into viable strategies when implementing multi-level hand-washing interventions. This review also adds to the existing evidence that multi-level hand-washing interventions can reduce the incidence of diarrhoea, respiratory infections, and school absenteeism. Further evidence-based studies are needed with improved methodological rigour in developing countries, to inform policy in this area.

Keywords: developing countries; diarrhoea; hand washing; multi-level intervention; respiratory infections; schoolchildren; strategies.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
See this image and copyright information in PMC

References

    1. Rao C., Lopez A.D., Hemed Y. Causes of death. In: Jamison D.T., Feachem R.G., Makgoba M.W., Bos E.R., Baingana F.K., Hofman K.J., Rogo K.O., editors. Disease and Mortality in Sub-Saharan Africa. 2nd ed. The International Bank for Reconstruction and Development/The World Bank; Washington, DC, USA: 2006. Chapter 5. - PubMed
    1. Lee R.L., Loke A.Y., Wu C.S., Ho A.P. The lifestyle behaviours and psychosocial well-being of primary school students in Hong Kong. J. Clin. Nurs. 2010;19:1462–1472. doi: 10.1111/j.1365-2702.2009.03057.x. - DOI - PubMed
    1. Eshuchi R.C.E. Promoting Handwashing with Soap Behaviour in Kenyan Schools: Learning from Puppetry Trials among Primary School Children in Kenya. [(accessed on 10 December 2016)]; Available online: http://eprints.qut.edu.au/62022/1/Rufus_Eshuchi_Thesis.pdf.
    1. Bloomfield S.F., Aiello A.E., Cookson B., O’Boyle C., Larson E.L. The effectiveness of hand hygiene procedures in reducing the risk of infections in homes and community settings including handwashing and alcohol-based hand sanitizers. Am. J. Infect. Control. 2007;35:S27–S64. doi: 10.1016/j.ajic.2007.07.001. - DOI
    1. Cairncross S., Hunt C., Boisson S., Bostoen K., Curtis V., Fung I.C., Schmidt W.-P. Water, sanitation and hygiene for the prevention of diarrhea. Int. J. Epidemiol. 2010;39:i193–i205. doi: 10.1093/ije/dyq035. - DOI - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources