Impact of a School-Based Hygiene Promotion and Sanitation Intervention on Pupil Hand Contamination in Western Kenya: A Cluster Randomized Trial
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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DOI：
10.4269/ajtmh.2012.11-0633
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发表时间：
2012-09-01
影响因子：
3.3
通讯作者：
Rheingans, Richard
中科院分区：
文献类型：
--
作者：
Greene, Leslie E.;Freeman, Matthew C.;Rheingans, Richard
用肥皂洗手可以有效地减少接触引起腹泻的病原体。改善低收入国家学校个人卫生和环境卫生条件的干预措施得到了更多的关注；然而，它们对学童接触粪便病原体的影响尚未确定。我们的试验考察了以学校为基础的水、环境卫生和个人卫生干预是否减少了肯尼亚西部学生手上的大肠杆菌污染。卫生宣传和水处理干预并未降低大肠杆菌存在的风险（相对危险度[RR] = 0.92, 95%可信区间[CI] = 0.54-1.56）；在干预学校增设新厕所显著增加了女孩患病风险（RR = 2.63, 95% CI = 1.29-5.34），而男孩患病风险无显著增加（RR = 1.36, 95% CI = 0.74-2.49）。通过建造新设施来增加学校厕所使用率的努力可能会对儿童构成风险，因为缺乏足够的卫生行为改变、每日提供肥皂和水以及肛门清洁材料。
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.