Stephen P. Luby, M.D., of the Centers for Disease Control and Prevention, Atlanta, presented the findings of the study today at a JAMA media briefing at the National Press Club in Washington, D.C.
Nearly 2 million children worldwide die annually from diarrheal disease, according to background information in the article. Previous studies have estimated that handwashing promotion interventions could prevent 1 million child deaths per year. Washing hands with soap prevents diarrhea, but children at the highest risk of death from diarrhea are younger than 1 year, too young to wash their own hands. Previous studies could not adequately assess the impact of household handwashing on diarrhea in infants.
Dr. Luby and colleagues evaluated whether promotion of handwashing with soap among adult and children household members decreased diarrhea among children at the highest risk of death from diarrhea. The study was conducted among 36 low-income neighborhoods in urban squatter settlements in Karachi, Pakistan. Eligible households located in the study area had at least 2 children younger than 15 years, at least 1 of whom was younger than 5 years.
As part of the intervention, field workers visited participating households at least weekly from April 2002 to April 2003 in 25 neighborhoods to provide education to all household members old enough to understand about proper handwashing with soap after defecation and before preparing food, eating, and feeding a child. They used slide shows, videotapes, and pamphlets to illustrate health problems resulting from contaminated hands. Within intervention neighborhoods, 300 households (1,523 children) received a regular supply o
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