Am J Trop Med Hyg. 2012 Jul 16.
Impact of a School-Based Hygiene Promotion and Sanitation Intervention on Pupil Hand Contamination in Western Kenya: A Cluster Randomized Trial.
Greene LE, Freeman MC, Akoko D, Saboori S, Moe C, Rheingans R.
Center for Global Safe Water, Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia; Tropical Institute of Community Health and Development, Great Lakes University of Kisumu, Kenya; Center for Global Safe Water, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Global and Environmental Health, University of Florida, Gainesville, Florida.
Abstract – 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.
