Waterless hand sanitizer for diarrhea prevention in a humanitarian emergency

用于在人道主义紧急情况下预防腹泻的无水洗手液

• 批准号: 8462085
• 负责人: Pavani Kalluri Ram
• 金额: $ 40.97万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2014-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8462085
• 关键词: Waterless; hand; sanitizer; diarrhea; prevention

DESCRIPTION (provided by applicant): Diarrhea and acute respiratory infections account for nearly 30% of deaths among children displaced due to humanitarian emergencies, with diarrhea causing up to 40% of child deaths in acute emergency settings. Intense crowding and acute and chronic malnutrition contribute to the high burden of diarrhea and acute respiratory infection. Sanitation infrastructure can be overwhelmed quickly with the influx of displaced persons and water quality can be poor, contributing to the high diarrhea risk. Repeatedly, handwashing has been shown to be infrequent at times relevant to pathogen transmission. But, there is a wealth of evidence supporting the impact of handwashing promotion for prevention of both diarrhea and acute respiratory infections. Provision of soap to a refugee population has been shown to lead to maintenance of soap in the home, and fewer episodes of diarrhea in households with soap in the home. Water scarcity represents a critical barrier to handwashing with soap and water, particularly in the displaced persons' camp setting. Maintaining water for handwashing in small containers is a constant challenge, particularly when handwashing facilities are shared amongst unrelated households. The hectic nature of life in a displaced persons' settlement may further challenge adherence to handwashing with water and soap at various critical times. Waterless hand sanitizer has been adopted widely in high-income settings because of its efficiency, convenience, and elimination of the need for water. Many waterless sanitizers contain alcohol but alternative options, such as chlorhexidine gel, have similar antimicrobial efficacy and may be more acceptable to some populations with religious or cultural proscriptions against alcohol. In the humanitarian emergency context, a waterless method of improving hand hygiene could overcome water supply concerns, require less frequent replenishment than water, and represent an efficient method of hand cleansing at critical times. Moreover, waterless hand sanitizer can be efficiently distributed as part of hygiene kits. In the context of an ongoing humanitarian emergency, we propose to evaluate the acceptability of two formulations of waterless hand sanitizers, and to measure the impact of provision and promotion of waterless hand sanitizer on hand cleansing behavior and effectiveness for prevention of diarrhea morbidity and mortality. We will use qualitative research methods to investigate the acceptability and barriers to use of alcohol-based and non-alcohol based waterless hand sanitizers. We will distribute the most acceptable formulation in a displaced persons' settlement and evaluate uptake and impact of sanitizer uptake on diarrhea morbidity. Using a case-control study approach, we will evaluate the association between sanitizer uptake and diarrhea mortality. This innovative study will inform public health approaches to prevent unconscionably high rates of diarrhea mortality among young children affected by humanitarian emergencies. PUBLIC HEALTH RELEVANCE: During humanitarian emergencies, young children are particularly vulnerable to diarrhea episodes and death. We propose to understand whether use of hand sanitizer in the refugee camp setting will result in a decrease in diarrhea-related cases and deaths. This innovative project will inform international efforts to prevent diarrhea mortality among young children in humanitarian emergencies.

描述（由申请人提供）：腹泻和急性呼吸道感染占由于人道主义紧急情况而流离失所的儿童死亡的近30％，在急性紧急情况下，腹泻造成多达40％的儿童死亡。强烈的拥挤，急性和慢性营养不良会导致腹泻和急性呼吸道感染的高负担。随着流离失所者的流入和水质的涌入，卫生基础设施可能会迅速淹没，这会导致高腹泻风险。反复地，有时与病原体传播相关的洗手是很少见的。但是，有大量证据支持促进促进对预防腹泻和急性呼吸道感染的影响。向难民人口提供的肥皂已被证明可导致家庭中的肥皂维护，而家庭中肥皂的腹泻发作较少。缺水代表了用肥皂和水洗手的关键障碍，尤其是在流离失所者的营地环境中。维持在小容器中洗手的水是一个持续的挑战，尤其是当无关家庭中的洗手设施分享时。流离失所者定居的生活的忙碌本质可能会进一步挑战遵守在各个关键时期用水和肥皂洗手的依从性。由于其效率，便利性和消除对水的需求，无水洗手液在高收入环境中被广泛采用。许多无水消毒剂含有酒精，但替代选择，例如氯己定凝胶，具有相似的抗菌功效，并且对于某些宗教或文化禁止对酒精的宗教或文化禁止的人群可能会更接受。在人道主义的紧急情况下，一种无水改善手卫生的方法可以克服供水问题，需要比水的频繁补给，并且代表了在关键时期有效的手动清洁方法。此外，无水洗手液可以作为卫生套件的一部分有效分布。在持续不断的人道主义紧急情况下，我们建议评估两种无水洗手液配方的可接受性，并衡量提供和促进无水洗手液对手动清洁行为的影响以及预防腹泻发病率和死亡率的有效性。我们将使用定性研究方法来研究使用基于酒精和非酒精的无水洗手液的可接受性和障碍。我们将在流离失所者的定居点中分发最可接受的配方，并评估消毒剂摄取对腹泻发病率的吸收和影响。使用病例对照研究方法，我们将评估消毒剂摄取和腹泻死亡率之间的关联。这项创新的研究将为公共卫生方法提供信息，以预防受人道主义紧急情况影响的幼儿中不受欢迎的腹泻死亡率。 公共卫生相关性：在人道主义紧急情况下，幼儿特别容易受到腹泻事件和死亡的影响。我们建议了解在难民营环境中使用手动消毒剂是否会导致与腹泻有关的病例和死亡减少。这个创新的项目将为防止腹泻死亡的国际努力提供信息 在人道主义紧急情况下的幼儿中。