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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Systematic review: Hygiene and health: Systematic review of handwashing practices worldwide and update of health effects
Tropical Medicine and International Health, Volume 19, No. 8, Year 2014
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Description
Objective: To estimate the global prevalence of handwashing with soap and derive a pooled estimate of the effect of hygiene on diarrhoeal diseases, based on a systematic search of the literature. Methods: Studies with data on observed rates of handwashing with soap published between 1990 and August 2013 were identified from a systematic search of PubMed, Embase and ISI Web of Knowledge. A separate search was conducted for studies on the effect of hygiene on diarrhoeal disease that included randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined. The search used Cochrane Library, Global Health, BIOSIS, PubMed, and Embase databases supplemented with reference lists from previously published systematic reviews to identify studies published between 1970 and August 2013. Results were combined using multilevel modelling for handwashing prevalence and meta-regression for risk estimates. Results: From the 42 studies reporting handwashing prevalence we estimate that approximately 19% of the world population washes hands with soap after contact with excreta (i.e. use of a sanitation facility or contact with children's excreta). Meta-regression of risk estimates suggests that handwashing reduces the risk of diarrhoeal disease by 40% (risk ratio 0.60, 95% CI 0.53-0.68); however, when we included an adjustment for unblinded studies, the effect estimate was reduced to 23% (risk ratio 0.77, 95% CI 0.32-1.86). Conclusions: Our results show that handwashing after contact with excreta is poorly practiced globally, despite the likely positive health benefits. © 2014 John Wiley & Sons Ltd.
Authors & Co-Authors
Freeman, Matthew Charles
Unknown Affiliation
Stocks, Meredith
Unknown Affiliation
Cumming, Oliver
Unknown Affiliation
Jeandron, Aurelie
Unknown Affiliation
Higgins, Julian P.T.
Unknown Affiliation
Wolf, Jennyfer
Unknown Affiliation
Prüss-Üstün, Annette M.
Unknown Affiliation
Bonjour, Sophie
Unknown Affiliation
Hunter, Paul R.
Unknown Affiliation
Fewtrell, Lorna
Unknown Affiliation
Curtis, Val A.
Unknown Affiliation
Statistics
Citations: 420
Authors: 11
Affiliations: 11
Identifiers
Doi:
10.1111/tmi.12339
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Environmental
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Case-Control Study
Study Approach
Systematic review