This paper seeks to identify the common behaviours of kitchen staff when using the tap and practices of washing hands. The study involved the reporting of a mixed method research design. All water ...usage practices and hand washing behaviour observed during the fieldwork process were noted. During general kitchen activities, staff only closed the taps properly nine times and left the taps open four times for the duration of the activity only. Taps left open during cleaning procedures occurred 24 times. Furthermore, taps were not properly closed 12 times. Staff took soap from the dispenser first, 29 times before opening the tap. The water used for rinsing hands was caught in a basin nine times and wiping hands with a wet cloth instead of washing with water and soap occurred twice. There is some form of awareness regarding hand hygiene and the practice of saving water, but not as evident during various other kitchen activities. Work-specific focus needs to take place to achieve water saving in the restaurant sector. A repetition of this study may lead to interesting finds on how the pandemic changed the hand washing awareness of kitchen staff whilst water shortages are occurring.
Introduction: Water, Sanitation, and Hygiene (WASH) can be used as an indicator for the assessment of the health of a country. Without WASH facilities, it is very difficult for the sustenance of ...health and well-being of the people. Aim: This systematic review tries to bring out various nuances of practices on WASH and their intervention in the South-East Asia Region (SEAR). Materials and Methods: In the present systematic review, searches were made systematically in scholarly sources like Google Scholar, PubMed, and Science Direct to unearth data from January 2005 to February 2020 with a language restriction to English for all the published articles. The literature search was conducted from March 2020 to May, 2020. The full-text articles (accessible) were retrieved from each of the searches and a few of the papers which appeared to be relevant were obtained for review. Articles were included from both urban and rural set-ups. Irrelevant topics and headings were excluded. Results: The area of SEAR has a different level of practice and outcomes on WASH. The studies show that low-quality WASH practices in Bangladesh, India, and Sri Lanka contribute to public health issues. The studies on the health impact of WASH from many countries like Indonesia, Myanmar, Sri Lanka, and Timor-Leste are also found to be inadequate in the maintenance of health. The report mentioned about many diseases like gastroenteritis, stunting, and helminthes infection among many people in the community. The source of drinking water, and drinking water quality needs to be assessed according to the recommendation of studies across the SEAR region. Two infectious diseases recently emerged such as Soil Transmitted Helminths (STH) and E Coli contamination due to inadequate WASH practices. Conclusion: The diarrhoeal diseases and sanitation-related issues are numerous in the entire region. Diverse consumption of sanitary practices and drinking water is seen in India, as reported in one study; whereas open defecation has not been eliminated as reported in another study, where 32% of households are still defecating openly. Health impacts due to the lack of proper WASH practices are still a rising concern. Special attention is required for underprivileged areas like slums and rural areas. The involvement of the government in providing WASH facilities to underprivileged people is very significant.
This paper aimed to establish the relationship between food safety knowledge, food shopping attitude, and self-reported kitchen practices among Romanian consumers. The study used data collected in an ...online survey applied on 985 consumers. A knowledge, attitude and practice (KAP) model applied by structural equation modelling revealed significant correlations between knowledge and attitude (r = 0.36; p < 0.001). Also, knowledge and attitude depicted significant effects on self-reported safety kitchen practices (β = 0.17, p < 0.001; β = 0.47, p < 0.001) and explained 30% of the variance of the food safety practices applied by Romanian consumers. These findings suggest that higher levels of food safety knowledge than current ones could conduct to an improved attitude towards food shopping priorities and could incline consumers to adopt adequate food safety practices during food purchasing in shops and food manipulation in their kitchens. Case-studies from real life situations (an observational study including 15 Romanian households) support the findings of this study and urge interventions to improve consumers’ food safety practices at home.
•Romanian consumers showed moderate awareness on kitchen hygiene practices.•Food safety, shopping attitude and kitchen hygiene practices were explained by KAP.•Food safety knowledge was correlated with food shopping attitude.•Food shopping attitude is reflected on kitchen hygiene practices.•Consumers’ knowledge on pathogens is influencing kitchen hygiene practices.
Hands are a route of transmission for fecal-oral pathogens. This analysis aimed to assess associations between hand E. coli contamination and child age and determine if observed hand cleanliness can ...serve as a proxy for E. coli contamination on young children's hands.
Trained field workers collected hand rinse samples from children aged 1-14 months in 584 households in rural Bangladesh and assessed the visual cleanliness of child hands (fingernails, finger pads and palms). Samples were analyzed using the IDEXX most probable number (MPN) methodto enumerate E. coli. We assessed if child age (immobile children aged 1-4 months vs. mobile children aged 5-14 months) is associated with log10 E. coli counts on hands using generalized estimating equations (GEE). We estimated the log10 difference in hand E. coli counts associated with the cleanliness of different hand parts using a multivariable GEE model.We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for dirty fingernails, fingerpads, palms and overall hands (the three observed parts combined) against binary E. coli presence on hands.
E. coli was detected on 43% of child hands. Children in the mobile age range had 0.17 log10 MPN higher E. coli on hands than those in the immobile age range (Δlog10 = 0.17, 95% CI = 0.02, 0.32, p = 0.03). Children with visible dirt particles on finger pads had 0.46 log10 MPN higher E. coli on hands than those with clean finger pads (Δlog10 = 0.46, 95% CI = 0.05, 0.87, p = 0.03). Dirty fingernails indicated binary E. coli presence with 81% sensitivity and 26% specificity while dirty fingerpads and palms indicated E. coli presence with 29% sensitivity and 75-77% specificity. The PPV was 45-48% and NPV 59-65% for all three types of observations.
Hand contamination with E. coli was prevalent among young children in rural Bangladesh, with higher levels of contamination among mobile children. Studies should assess if strategies to remove animal feces from the courtyard, provide designated hygienic play spaces for children and deliver targeted messaging to mothers to wipe or wash children's hands after contact with animals and animal feces reduce child hand contamination. Visible hand cleanliness was a poor predictor of E. coli presence on young children's hands so other low-cost field measurements are needed to accurately detect fecal contamination on hands.
Sustainability of hand hygiene is challenging in low resource settings. Adding ownership and goal setting to the WHO-5 multimodal intervention may help sustain high compliance.
To increase and ...sustain compliance of nursing and medical staff with hand hygiene in a tertiary referral center with limited resources.
A quality improvement initiative was conducted over two years (2016-2018). After determining baseline compliance rates, the WHO-5 multimodal intervention was implemented with staff education and training, system change, hospital reminders, direct observation and feedback, and hospital safety climate. Additionally, the medical staff was responsible for continuous surveillance of compliance (ownership) until rates above 90% were achieved and sustained (goal setting).
Of 2987 observations collected between August 2016 and April 2018, 1630 (54.5%) were before, and 1357 (45.5%) were after patient encounters. The average overall compliance with hand hygiene was sustained at 94% for nursing and medical staff. Two instances of drops below 90% were associated with incidence of nosocomial Rotavirus infections. There were no similar infections during intervention periods with compliance rates above the set goal. Analysis using p-charts revealed significant improvement in compliance rates from baseline (χ2 (1) = 7.94, p = 0.005).
Adding ownership and goal setting to the WHO-5 multimodal intervention may help achieve, and sustain high rates of compliance with hand hygiene. Involving health care workers in quality improvement initiatives is feasible, durable, reliable, and cheap, especially in settings with limited financial resources.
Soil-transmitted helminths (STH) remain one of the most common causes of morbidity among children in Ethiopia. Assessment of the magnitude of STH and its association with water, sanitation, and ...hygiene (WASH) and identify barriers for school-level prevention assist public health planners to prioritize promotion strategies and is a basic step for intervention. However, there is a lack of evidence on the prevalence of STH and its association with WASH and barriers for school-level prevention among schoolchildren. To assess the prevalence of STH and its association with WASH and identify barriers for school level prevention in technology village of Hawassa University; 2019. An institution-based analytical cross-sectional study was conducted on a sample of 1080 schoolchildren from September 5 to October 15, 2019. A two-stage cluster and purposive sampling technique were used to draw the study participants. A pretested, structured questionnaire, observation checklist, and in-depth interview were used to collect the data. Two grams of stool samples were collected from each study participant and examined using direct wet mount and Kato-Katz technique. Data were entered into Epi Info version 7 and analyzed using SPSS version 25. Both bi-variable and multivariable logistic regression analyses were done. Qualitative data were analyzed using thematic content analysis method by Atlas-Ti software and presented in narratives. The overall prevalence of STHs was 23.1% (95% CI = 21.4, 27.6). The identified predictors of STHs were large family size (AOR = 2.03; 95% CI = 1.53-3.99), absence of separate toilet room for male and female (AOR = 3.33; 95% CI = 1.91-5.79), toilet not easy to clean (AOR = 2.17; 95% CI = 1.44-3.33), inadequate knowledge about STHs (AOR = 2.08; 95% CI = 1.07-3.44) and children who had travelled greater than 100 meters to access toilet (AOR = 3.45; 95% CI = 2.24-8.92). These results were supported by the individual, institutional, socio-economic and cultural qualitative results. The STHs was moderate public health concerns. Reinforcing the existing fragile water, sanitation and hygiene programs and regular deworming of schoolchildren may support to reduce the burden of STHs. Also, increasing modern family planning methods utilization to decrease family size is recommended.
Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19. In this paper we ...outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex. The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered. Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63). Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented. In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation. In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems. In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries. We consider how theoretical elements of Co-Creation can inform effective international public health interventions; crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19. Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'.
Soil-transmitted helminth (STH) infections are highly prevalent in resource-limited countries. We assessed the effect of a combination intervention aiming to enhance handwashing with soap on STH ...reinfection following mass drug administration among primary school children in Kagera region, Northwestern Tanzania.
We conducted a cluster randomised trial in sixteen primary schools with known high STH prevalence. Schools were randomly assigned in a 1:1 ratio to either receive the intervention or continue with routine health education. The intervention included teacher-led classroom teaching, parental engagement sessions, environmental modifications and improved handwashing stations. The evaluation involved two cross-sectional surveys in a representative sample of students, with the end-line survey conducted 12 months after the baseline survey. The primary outcome was the combined prevalence of Ascaris lumbricoides and Trichuris trichiura infections at the end-line survey. Secondary outcomes included reported handwashing behaviour, the prevalence and intensity of individual STHs, and hand contamination with STH ova and coliform bacteria. End-line STH prevalence and intensity were adjusted for baseline differences of potential confounders.
At the end-line survey, 3081 school children (1566 from intervention schools and 1515 from control schools) provided interview data and stool specimens. More school children in the intervention group reported the use of water and soap during handwashing compared to school children in the control group (58% vs. 35%; aOR=1.76, 95%CI 1.28-2.43, p=0.001). The combined prevalence of A. lumbricoides and T. trichiura infections was 39% in both trial arms (aOR = 1.19; 95%CI 0.74-1.91). The prevalence of A. lumbricoides was 15% in the intervention and 17% in the control arm (aOR =1.24, 95%CI 0.59-2.59) and that of T. trichiura was 31% in both arms (aOR=1.17, 95%CI 0.73-1.88). No significant differences were found for STH infection intensity in both the main study and the hand contamination sub-study.
The intervention was effective in increasing reported handwashing behaviour at school, but failed to show a similar effect in the home. The intervention had no effect on STH infection, possibly due to infection in the home environment, other transmission routes such as contaminated water or food or limited changes in school children's handwashing behaviour.
The trial was registered on June 21, 2017, by the International Standard Randomised Controlled Trial Number ( ISRCTN45013173) .
Pendahuluan : Edukasi melalui pendidikan kesehatan menjadi salah satu dari upaya pencegahan penyakit diare pada anak. Kunci keberhasilan pendidikan kesehatan pada anak terketak pada media yang ...digunakan, media ular tangga dan media audio visual menjadi media yang dapat digunakan dalam pendidikan kesehatan pada anak, namun belum ada penelitian terkait perbedaan efektivitasnya pada pengetahuan tentang cuci tangan pada anak usia sekolah. Tujuan: membandingkan efektivitas dan membandingkan perbedaan efektivitas media ular tangga dan media audio visual terhadap pengetahuan anak tentang cuci tangan pada anak usia sekolah. Metode: Eksperimen dengan desain quasi experimental dengan teknik nonequivalent pretest posttest, random sampling menjadi teknik pengambilan sampel, dengan responden anak usia sekolah dan jumlah 80 yang terdiri dari 40 kelompok intervensi pendidikan kesehatan dengan media ular tangga dan 40 kelompok intervensi media audio visual, data diukur sebelum dan sesudah intervensi pada kelompok kedua kelompok, data dianalisa dengan uji Wilcoxon, serta uji Manwhitney. Hasil : Media ular tangga efektif meningkatkan pengetahuan anak dengan p value 0,001<0,05 dan media audio visual sama efektif meningkatkan pengetahuan anak dengan p value 0,008<0,05, sedangkan uji manwhitney menunjukan tidak terdapat perbedaan signifikan hasil posttest diantara kelompok intervensi tersebut dengan nilai 0,241>0,05. Simpulan: Media ular tangga dan media audio visual sama efektif dalam meningkatkan pengetahuan anak tentang cuci tangan, sehingga ini dapat menjadi landasan media untuk health promotion oleh stake holder yang terkait.
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