Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.689
Filtrar
1.
Nurs Stand ; 35(5): 45-50, 2020 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-32337862

RESUMO

Decontamination using hand hygiene remains one of the most important and effective methods for reducing healthcare-associated infections and cross-infection between patients. In 1860, Florence Nightingale wrote that nurses should wash their hands frequently throughout the day, demonstrating an early awareness of the effectiveness of this simple procedure. The COVID-19 pandemic has demonstrated that effectively applied hand hygiene is a vital intervention that can be used to prevent the spread of disease. This article details the correct procedure required for effective hand hygiene and emphasises the need for nurses to keep up to date with evidence-based guidelines. The article also outlines the differences between hand decontamination using alcohol-based hand gels and soap and water, and the complex factors that can interfere with effective hand hygiene compliance.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar , Fidelidade a Diretrizes , Higiene das Mãos , Controle de Infecções , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Desinfecção das Mãos/métodos , Humanos , Controle de Infecções/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
2.
PLoS One ; 15(2): e0228482, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32012206

RESUMO

BACKGROUND: Children in humanitarian situations are particularly vulnerable to diseases such as diarrhoea. Handwashing with soap can greatly reduce transmission but handwashing rates are often low and traditional interventions ineffective. To aid future intervention design, this study aims to understand the determinants of child handwashing and the key motivational drivers of children's behaviour within a specific humanitarian setting. METHODS: In an internally displaced persons camp in Northern Iraq we conducted a series of 36 friendship-paired interviews with children aged 7-12 years, six semi-structured caregiver interviews, and three semi-structured hygiene promoter interviews. Perceived determinants of child handwashing were explored qualitatively, and motivational drivers were explored quantitatively with children in a rating exercise. Qualitative data were analysed thematically, using an inductive approach, and logistic regression analyses of motive rating data were performed to determine the predicted probabilities of motives being rated as important. RESULTS: Access to soap and water was perceived to be high across all participant groups. Children, caregivers and hygiene promoters all perceive the determinants of child handwashing to be associated with familial role, environmental factors pertaining to location and quality of handwashing materials and facilities, and level of exposure to hygiene promotion, and children also attribute their handwashing to social norms. We find that children in this context are motived most by play and nurture. CONCLUSIONS: Provision of soap and water alone is not sufficient to encourage children to practice handwashing with soap in a humanitarian context. Our findings suggest that equal consideration should be given to the quality and location of handwashing materials and facilities and social norms could be leveraged to promote and enhance child handwashing. Motive-based interventions targeting play or nurture may be a promising approach and are likely most effective when used in conjunction, along with other motivational drivers such as affiliation and love.


Assuntos
Comportamento Infantil/fisiologia , Desinfecção das Mãos , Higiene , Motivação , Refugiados/estatística & dados numéricos , Cuidadores/estatística & dados numéricos , Criança , Família , Feminino , Desinfecção das Mãos/métodos , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Humanos , Iraque/epidemiologia , Masculino , Sabões , Normas Sociais
3.
PLoS One ; 15(2): e0229655, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32106240

RESUMO

Handwashing with soap is an important preventive health behavior, and yet promoting this behavior has proven challenging. We report the results of a program that trained teachers to deliver a handwashing with soap behavior change program to children in primary schools in Bihar, India. Ten intervention schools selected along with ten nearby control schools, and intervention schools received the "School of Five" program promoting handwashing with soap using interactive stories, games, and songs, behavioral diaries to encourage habit formation, and public commitment. Households with children aged 8-13 attending the nearby school were enrolled in the study. Handwashing with soap was measured using sticker diaries before eating and after defecation 4 weeks after the intervention was completed. Children in the treatment reported 15.1% more handwashing with soap on key occasions (35.2%) than those in the control group (20.1%) (RR: 1.77, CI: (1.22, 2.58), p = .003). There was no evidence that handwashing with soap after defecation was higher in the treatment group than the control group (RR: 1.18, CI: (0.88, 1.57), p = .265), but there was strong evidence that handwashing with soap was greater in the treatment than in the control before eating (RR: 2.68, 95% CI: (1.43, 5.03), p = .002). Rates of handwashing increased both at home (RR: 1.63, CI: 1.14, 2.32), p = .007) and at school (RR: 4.76, 95% CI: (1.65, 17.9), p = .004), though the impact on handwashing with soap at key occasions in schools was much higher than at home. Promoting handwashing with soap through teachers in schools may be an effective way to achieve behavior change at scale.


Assuntos
Desinfecção das Mãos/métodos , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Instituições Acadêmicas , Adolescente , Adulto , Criança , Características da Família , Feminino , Humanos , Índia , Masculino , Saúde Pública/métodos , Professores Escolares , Sabões
5.
PLoS One ; 14(12): e0226548, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31841540

RESUMO

BACKGROUND: Poor water sanitation and hygiene (WASH) in health care facilities increases hospital-associated infections, and the resulting greater use of second-line antibiotics drives antimicrobial resistance. Recognising the existing gaps, the World Health Organisations' Water and Sanitation for Health Facility Improvement Tool (WASH-FIT) was designed for self-assessment. The tool was designed for small primary care facilities mainly providing outpatient and limited inpatient care and was not designed to compare hospital performance. Together with technical experts, we worked to adapt the tool for use in larger facilities with multiple inpatient units (wards), allowing for comparison between facilities and prompt action at different levels of the health system. METHODS: We adapted the existing facility improvement tool (WASH-FIT) to create a simple numeric scoring approach. This is to illustrate the variation across hospitals and to facilitate monitoring of progress over time and to group indicators that can be used to identify this variation. Working with stakeholders, we identified those responsible for action to improve WASH at different levels of the health system and used piloting, analysis of interview data to establish the feasibility and potential value of the WASH Facility Survey Tool (WASH-FAST) to demonstrate such variability. RESULTS: We present an aggregate percentage score based on 65 indicators at the facility level to summarise hospitals' overall WASH status and how this varies. Thirty-four of the 65 indicators spanning four WASH domains can be assessed at ward level enabling within hospital variations to be highlighted. Three levels of responsibility for WASH service monitoring and improvement were identified with stakeholders: the county/regional level, senior hospital management and hospital infection prevention and control committees. CONCLUSION: We propose WASH-FAST can be used as a survey tool to assess, measure and monitor the progress of WASH in hospitals in resource-limited settings, providing useful data for decision making and tracking improvements over time.


Assuntos
Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Higiene das Mãos/normas , Saneamento/normas , Inquéritos e Questionários/normas , Purificação da Água/normas , Organização Mundial da Saúde , Infecção Hospitalar/prevenção & controle , Estudos de Viabilidade , Saúde Global , Implementação de Plano de Saúde/normas , Hospitais , Humanos , Guias de Prática Clínica como Assunto/normas , Melhoria de Qualidade , Saneamento/métodos , Fatores de Tempo , Purificação da Água/métodos , Abastecimento de Água/normas
6.
BMC Infect Dis ; 19(1): 1066, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856747

RESUMO

BACKGROUND: Symptomatic and asymptomatic enteric infections in early childhood are associated with negative effects on childhood growth and development, especially in low and middle-income countries, and food may be an important transmission route. Although basic food hygiene practices might reduce exposure to faecal pathogens and resulting infections, there have been few rigorous interventions studies to assess this, and no studies in low income urban settings where risks are plausibly very high. The aim of this study is to evaluate the impact of a novel infant food hygiene intervention on infant enteric infections and diarrhoea in peri-urban settlements of Kisumu, Kenya. METHODS: This is a cluster randomized control trial with 50 clusters, representing the catchment areas of Community Health Volunteers (CHVs), randomly assigned to intervention or control, and a total of 750 infants recruited on a rolling basis at 22 weeks of age and then followed for 15 weeks. The intervention targeted four key caregiver behaviours related to food hygiene: 1) hand washing with soap before infant food preparation and feeding; 2) bringing all infant food to the boil before feeding, including when reheating or reserving; 3) storing all infant food in sealed containers; and, 4) using only specific utensils for infant feeding which are kept separate and clean. RESULTS: The primary outcome of interest is the prevalence of one or more of 23 pre-specified enteric infections, determined using quantitative real-time polymerase chain reaction for enteric pathogen gene targets. In addition, infant food samples were collected at 33 weeks, and faecal indicator bacteria (Enterococcus) isolated and enumerated to assess the impact of the intervention on infant food contamination. CONCLUSION: To our knowledge this is the first randomized controlled trial to assess the effect of an infant food hygiene intervention on enteric infections in a high burden, low income urban setting. Our trial responds to growing evidence that food may be a key pathway for early childhood enteric infection and disease and that basic food hygiene behaviours may be able to mitigate these risks. The Safe Start trial seeks to provide new evidence as to whether a locally appropriate infant food hygiene intervention delivered through the local health extension system can improve the health of young children. TRIAL REGISTRATION: The trial was registered at clinicaltrial.gov on March 16th 2018 before enrolment of any participants (https://clinicaltrials.gov/ct2/show/NCT03468114).


Assuntos
Diarreia/epidemiologia , Diarreia/microbiologia , Enterite/epidemiologia , Enterite/microbiologia , Desinfecção das Mãos/métodos , Infecções/epidemiologia , Pobreza , Cuidadores , Culinária , Diarreia/prevenção & controle , Enterite/prevenção & controle , Enterococcus/isolamento & purificação , Fezes/microbiologia , Feminino , Contaminação de Alimentos/prevenção & controle , Armazenamento de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Doenças Transmitidas por Alimentos/prevenção & controle , Humanos , Lactente , Controle de Infecções , Infecções/microbiologia , Quênia/epidemiologia , Masculino , Saúde Pública , Sabões , Saúde da População Urbana
7.
BMC Res Notes ; 12(1): 647, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31590689

RESUMO

OBJECTIVE: This study aimed to determine the effect of awareness of subtle control after training on the hand hygiene compliance among nurses in intensive care units (ICUs). The study was conducted in two ICUs of a trauma center in Shiraz, Iran on 48 nurses. The nurses of one ICU were randomly allocated to the intervention and the nurses of the other ICU were allocated to the control group. All nurses were trained on hand hygiene. Then a fake closed camera television (CCTV) was visibly installed in the intervention group's ICU, while the nurses were aware of it. The degree of compliance with hand hygiene was observed in both groups before and after the intervention. Data were gathered using a checklist based on the World Health Organization hand hygiene protocol and analyzed using SPSS 16 and the Chi square, Wilcoxon, Mann-Whitney U, and Independent T-tests, were performed. RESULTS: The mean percentage of hand hygiene compliance in the intervention group after the intervention was significantly higher than before the intervention (p < 0.001). Additionally, the changes in the mean percentage of the intervention group was significantly higher than that for the control group (p = 0.001). The findings showed that a fake CCTV after training, installed in ICUs, can improve hand hygiene compliance.


Assuntos
Higiene das Mãos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções/estatística & dados numéricos , Unidades de Terapia Intensiva , Enfermeiras e Enfermeiros/estatística & dados numéricos , Lista de Checagem/normas , Lista de Checagem/estatística & dados numéricos , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Higiene das Mãos/métodos , Humanos , Controle de Infecções/métodos , Irã (Geográfico) , Enfermeiras e Enfermeiros/normas
8.
BMC Res Notes ; 12(1): 567, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511045

RESUMO

OBJECTIVE: The study aimed to assess enteropathogens carriage rate and risk factors among apparently healthy food handlers at Wolkite University cafeteria, Southern Ethiopia. RESULTS: Cross-sectional study was conducted among 170 food handlers to collect socio-demographic and related data by using structured questionnaires. Stool samples were collected and subjected to microscopic examination and cultured to determine intestinal parasites. Among the total study participants, 66% of them were found to be carriers of enteropathogens: bacteria (Salmonella typhi, Shigella species), and intestinal parasites (Ascaris lumbricoides,Taenia species, Giardia lamblia, Entameoba histolytica/dispar, Enterobius vermicularis, Hook worm and Trichuris trichiura). All Salmonella and Shigella isolates were sensitive to ceftriaxone, ciprofloxacin, and gentamicin. A significant association was found between hand washing practice before food preparation and isolated pathogens [p = 0.013]. A significant proportion of food handlers were found to be carriers of pathogens which require a periodic screening and antibiotic therapy monitoring.


Assuntos
Fezes/microbiologia , Fezes/parasitologia , Manipulação de Alimentos/normas , Serviços de Alimentação/normas , Desinfecção das Mãos/normas , Universidades , Adolescente , Adulto , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Manipulação de Alimentos/métodos , Manipulação de Alimentos/estatística & dados numéricos , Serviços de Alimentação/estatística & dados numéricos , Desinfecção das Mãos/métodos , Humanos , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
9.
Int J Pharm Compd ; 23(5): 387-391, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31513537

RESUMO

In pharmaceutical compounding, strict adherence to a protocol for hand hygiene and glove sanitizing is essential to ensure the purity, safety, and effectiveness of sterile preparations; reduce patient morbidity and mortality; and decrease the cost of health care. Alcohols and chlorhexidine gluconate are among the most effective bactericides, virucides, and fungicides, and acquired resistance to those agents has not been shown in clinical practice. This article, which is part 1 in a series of 2, pertains primarily to alcohol-based hand rubs that are appropriate for use in sterile compounding (glove sanitizing is discussed as part of the handsanitizing process). In a brief overview of those products, we define pertinent terminology, examine the necessity of and requirements for the use of sanitizers, review their mechanism of action and composition, consider factors pertinent to their selection, and present a protocol for their application. In part 2 of this series, the topics examined include a comparison of various alcohol-based sanitizers and answers to compounders' frequently asked questions about their use.


Assuntos
Desinfecção das Mãos/métodos , Mãos , Mãos/microbiologia , Humanos
10.
mSphere ; 4(5)2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533996

RESUMO

Both antiseptic hand rubbing (AHR) using ethanol-based disinfectants (EBDs) and antiseptic hand washing (AHW) are important means of infection control to prevent seasonal influenza A virus (IAV) outbreaks. However, previous reports suggest a reduced efficacy of ethanol disinfection against pathogens in mucus. We aimed to elucidate the situations and mechanisms underlying the reduced efficacy of EBDs against IAV in infectious mucus. We evaluated IAV inactivation and ethanol concentration change using IAV-infected patients' mucus (sputum). Additionally, AHR and AHW effectiveness against infectious mucus adhering to the hands and fingers was evaluated in 10 volunteers. Our clinical study showed that EBD effectiveness against IAV in mucus was extremely reduced compared to IAV in saline. IAV in mucus remained active despite 120 s of AHR; however, IAV in saline was completely inactivated within 30 s. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the time required for the ethanol concentration to reach an IAV inactivation level and thus for EBDs to completely inactivate IAV was approximately eight times longer in mucus than in saline. On the other hand, AHR inactivated IAV in mucus within 30 s when the mucus dried completely because the hydrogel characteristics were lost. Additionally, AHW rapidly inactivated IAV. Until infectious mucus has completely dried, infectious IAV can remain on the hands and fingers, even after appropriate AHR using EBD, thereby increasing the risk of IAV transmission. We clarified the ineffectiveness of EBD use against IAV in infectious mucus.IMPORTANCE Antiseptic hand rubbing (AHR) and antiseptic hand washing (AHW) are important to prevent the spread of influenza A virus (IAV). This study elucidated the situations/mechanisms underlying the reduced efficacy of AHR against infectious mucus derived from IAV-infected individuals and indicated the weaknesses of the current hand hygiene regimens. Due to the low rate of diffusion/convection because of the physical properties of mucus as a hydrogel, the efficacy of AHR using ethanol-based disinfectant against mucus is greatly reduced until infectious mucus adhering to the hands/fingers has completely dried. If there is insufficient time before treating the next patient (i.e., if the infectious mucus is not completely dry), medical staff should be aware that effectiveness of AHR is reduced. Since AHW is effective against both dry and nondry infectious mucus, AHW should be adopted to compensate for these weaknesses of AHR.


Assuntos
Desinfetantes/farmacologia , Desinfecção das Mãos/normas , Vírus da Influenza A/efeitos dos fármacos , Influenza Humana/prevenção & controle , Muco/virologia , Etanol/farmacologia , Desinfecção das Mãos/métodos , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Vírus da Influenza A/fisiologia , Influenza Humana/transmissão , Viabilidade Microbiana , Muco/efeitos dos fármacos , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia
11.
Rev. cuba. estomatol ; 56(3): e1380, jul.-set. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1093237

RESUMO

RESUMEN Introducción: La técnica de lavado de manos quirúrgico es imprescindible para la prevención de las infecciones posoperatorias en el sitio de la intervención, lo que constituye un problema actual y en evolución. Objetivo: Determinar la técnica de lavado de manos quirúrgico con mayor eficacia sobre la flora bacteriana en estudiantes de cirugía. Métodos: Ensayo controlado, aleatorio, de tratamientos no farmacológicos. Se seleccionaron 12 estudiantes de cirugía de la Facultad de Odontología, Universidad de San Martín de Porres, que cumplían con los criterios de inclusión y exclusión. Los estudiantes se dividieron en dos grupos y se les asignó una técnica de lavado de manos quirúrgico: Grupo A: técnica de una fase, y Grupo B: técnica tradicional (tres fases); para ambas técnicas se utilizó escobilla y jabón en barra. Resultados: En el medio de cultivo agar manitol salado, la técnica tradicional presentó una mediana de 52 000 UFC/mL con un mínimo de 10 000 UFC/mL y un máximo de 56 800 UFC/mL, en comparación con la técnica de una fase que presentó 19 600 UFC/mL con un mínimo de 4 400 UFC/mL y un máximo de 38 000 UFC/mL, con un valor de p= 0,117. En el agar MacConkey, la técnica tradicional presentó una mediana de 300 UFC/mL con un mínimo de 0 UFC/mL y un máximo de 18 000 UFC/mL, en comparación con la técnica de una fase que presentó 0 UFC/mL, con un valor de p= 0,054. Conclusiones: No se mostraron diferencias estadísticamente significativas en ambos grupos(AU)


ABSTRACT Introduction: Surgical hand scrubbing is indispensable to prevent postoperative infection at the intervention site, a problem both current and in progress. Objective: Determine the most effective surgical hand scrubbing technique against bacterial flora among surgery students. Methods: A controlled randomized study was conducted of non-pharmacological treatments. Twelve surgery students were selected from the School of Dentistry at the University of San Martín de Porres who met the inclusion and exclusion criteria. The students were divided into two groups and assigned one of two surgical hand scrubbing techniques: Group A: one-step technique and Group B: traditional technique (three steps). Both techniques used bar soap and a brush. Results: In the culture medium mannitol salt agar, the traditional technique obtained a median of 52 000 CFU/mL, with a minimum 10 000 CFU/mL and a maximum 56 800 CFU/mL, whereas the one-step technique obtained a median of 19 600 CFU/mL, with a minimum of 4 400 CFU/mL and a maximum of 38 000 CFU/mL (p= 0.117). In MacConkey agar, the traditional technique obtained a median of 300 UFC/mL, with a minimum of 0 CFU/mL and a maximum of 18 000 CFU/mL, whereas the one-step technique obtained 0 UFC/mL (p= 0.054). Conclusions: No statistically significant differences were found in the groups(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Estudantes de Medicina , Infecções Bacterianas/prevenção & controle , Assepsia/métodos , Desinfecção das Mãos/métodos , Anti-Infecciosos Locais/administração & dosagem
12.
BMC Res Notes ; 12(1): 478, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375135

RESUMO

OBJECTIVE: Absence of latrine remains a common public health problem in most of the Sub-Saharan Africa countries. A cross-sectional study was conducted to assess the effect of community-led total sanitation and hygiene approach implementation and associated factors among villages of Laelai Maichew District, Tigray, and North Ethiopia. RESULTS: This study revealed that the rate of latrine use in the rural community of Laelai-Maichew district was about 46.8%. The majority, 71.1% of households in CLTSH implemented Villages and 93.5% of households in CLTSH non-implemented Villages did not have hand washing facility around their latrine. Community-led to total sanitation and hygiene non-implemented villages were 49% times less likely to utilize their latrine compared to those community-led total sanitation implemented villages [AOR = 0.51 95% CI (0.35, 0.75)]. Households owned latrines for two and above years were 1.5 more likely to utilize their latrine [AOR = 1.50 95% CI (1.21, 2.59)] than those of owning latrines for less than 2 years. In this study, latrine use rate was low. As a result, the local, national governmental and non-governmental organization should design programs to create behavioral changes on the community's attitude towards latrine utilization.


Assuntos
Higiene/normas , Saúde Pública/normas , População Rural/estatística & dados numéricos , Saneamento/normas , Adulto , Estudos Transversais , Etiópia , Feminino , Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Saneamento/métodos , Inquéritos e Questionários , Toaletes/normas , Toaletes/estatística & dados numéricos
13.
Artigo em Inglês | MEDLINE | ID: mdl-31311186

RESUMO

Nearly 90% of diarrhea-related mortalities are the result of unsafe drinking water, poor sanitation, and insufficient hygiene. Although "Water, Sanitation, and Hygiene" (WASH) interventions may significantly reduce the risk of diarrheal disease, it is currently unclear which interventions are the most effective. In this study, we aim to determine the importance of contextualizing a WASH intervention to the local context and the needs for increasing impact (Clinicaltrials.gov NCT03709368). A total of 1500 households in rural Tanzania will participate in this cluster randomized controlled trial. Households will be randomized into one of three cohorts: (1) a control group receiving a basic intervention and 1 placebo household visit, (2) an intervention group receiving a basic intervention + 9 additional household visits which are contextualized to the setting using the RANAS approach, and (3) an intervention group receiving a basic intervention + 9 additional household visits, which are not contextualized, i.e., a general intervention. Assessments will take place at a baseline, 1 and 2 years after the start of the intervention, and 1 year after the completion of the intervention. Measurements involve questionnaires and spot checks. The primary outcome is hand-washing behavior, secondary objectives include, the impact on latrine use, health, WASH infrastructure, quality of life, and cost-effectiveness.


Assuntos
Desinfecção das Mãos/métodos , Promoção da Saúde/métodos , Serviços de Saúde Rural , Saúde da População Rural , Saneamento/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Feminino , Seguimentos , Desinfecção das Mãos/normas , Comportamentos Relacionados com a Saúde , Promoção da Saúde/normas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Projetos de Pesquisa , Serviços de Saúde Rural/normas , Saneamento/normas , Método Simples-Cego , Tanzânia , Adulto Jovem
14.
BMC Res Notes ; 12(1): 399, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300042

RESUMO

OBJECTIVE: Food borne diseases are predominant in all parts of the world especially in urban areas and are the main source for food borne illness. The aim of this study is to assess sanitation status and its determinants among food establishments in Adwa town, North Ethiopia from March to June 2017. RESULTS: A total of 391 (95.4%) subjects were included in this study. Around 53.3% of food establishments in the study area were in a poor sanitary status. Presence of trained managers on hygiene and sanitation (AOR = 2.6, 95% CI 1.7-4.1); inspection by regulatory personnel (AOR = 1.95, 95% CI 1.36-22.4) and being licensed (AOR = 1.2 95% CI 1.11-2.51) were associated factors which affect sanitary status sanitary of the establishments. The overall sanitary status of the establishments in the study area was found unhygienic. Managers should gain trainings on food hygiene and sanitation to follow and improve the sanitary status of the establishments.


Assuntos
Manipulação de Alimentos/normas , Doenças Transmitidas por Alimentos/diagnóstico , Desinfecção das Mãos/normas , Saneamento/normas , Adulto , Idoso , Estudos Transversais , Etiópia/epidemiologia , Feminino , Alimentos/normas , Alimentos/estatística & dados numéricos , Manipulação de Alimentos/métodos , Manipulação de Alimentos/estatística & dados numéricos , Serviços de Alimentação/legislação & jurisprudência , Serviços de Alimentação/normas , Serviços de Alimentação/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Desinfecção das Mãos/métodos , Humanos , Higiene/normas , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Saneamento/estatística & dados numéricos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
15.
BMC Res Notes ; 12(1): 393, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300055

RESUMO

OBJECTIVE: The study aimed to assess the sanitary condition of services and its implication for intestinal parasitic infections among prison inmates in eastern Tigrai, northern Ethiopia. RESULTS: We have assessed the availability and sanitary condition of services at Adigrat prison. Frequent water cuts and unavailability of soap in the prison have challenged prisoners and food handlers to maintain their hygiene. The living rooms were overcrowded and poorly ventilated besides to unsatisfactory kitchen rooms. The prevalence of intestinal parasites among the participants was 40% (108/270). The dominant parasite was Entamoeba histolytica/dispar (60, 22.2%) followed by Giardia lamblia, 39 (14.4%). The mixed infections of Entamoeba histolytica/dispar and Giardia lamblia were detected among 17 (6.3%) of the participants. In multivariate analysis, participants who were feeding in groups were more likely to harbor intestinal parasites than those who were feeding alone (AOR: 2.1; CI 1.05-4.3). Intestinal parasites are significant health problems to the prisoners of Adigrat prison with poor sanitation of services. Therefore, provision of necessary facilities such as hand washing basins, soaps, disinfectants, disinfestations, and food utensils could significantly reduce the burden of intestinal parasites in the prison.


Assuntos
Enteropatias Parasitárias/diagnóstico , Prisioneiros/estatística & dados numéricos , Prisões , Saneamento/normas , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Fezes/parasitologia , Feminino , Desinfecção das Mãos/métodos , Humanos , Higiene/normas , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Adulto Jovem
16.
J Hosp Infect ; 103(1): e110-e114, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31278954

RESUMO

Splashing from handwash basins may be a source of bacteria in the healthcare environment. A novel splash-reducing basin was assessed for its ability to reduce droplet formation during simulated handwashing. The basin was compared to two conventional basins commonly used in healthcare. Basins were mounted in a test system and tap flushed for 30-s with and without handwashing. Droplets were visualized with fluorescent dye. With conventional basins, >1000 droplets were formed during 30-s flushes and found to spread further than 2-m. The novel basin significantly reduced the number of droplets formed during handwashing and reduced the distance spread.


Assuntos
Equipamentos e Provisões , Desinfecção das Mãos/instrumentação , Desinfecção das Mãos/métodos , Instalações de Saúde
17.
Clin Microbiol Infect ; 25(7): 851-856, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31203871

RESUMO

OBJECTIVES: Compliance with the World Health Organization 'how to handrub' action is suboptimal. Simplifying the hand-hygiene action may improve practice. However, it is crucial to preserve antibacterial efficacy. We tested the non-inferiority of 15 versus 30 seconds handrubbing for Staphylococcus aureus and Escherichia coli contamination at different loads, using hand-size customized alcohol-based handrub (ABHR) volumes. METHODS: In an EN1500-based study, 18 health-care workers (HCWs) with extensive experience in hand hygiene rubbed hands with a hand-size customized volume of isopropanol 60% v/v. They repeated the following sequence: hand contamination (E. coli or S. aureus; broth containing 108 or 106 CFU/mL); baseline fingertips sampling; handrubbing (15 or 30 seconds); re-sampling. The main outcome was log10 CFU corrected reduction factor (cRF) on HCWs' hands, applying a generalized linear mixed model with a random intercept for subject. RESULTS: The median cRF was 2.1 log10 (interquartile range 1.50-3.10). After fitting the model, cRF was significantly higher for S. aureus compared with E. coli but there was no significant effect for duration of handrubbing or contamination fluid concentration. Fifteen seconds of handrubbing was non-inferior to 30 (-0.06 log10, 95% CI -0.34 to 0.22; EN1500 0.60 log10 non-inferiority margin). This was confirmed in all pre-specified subgroups. CONCLUSION: Among experienced HCWs using a hand-size customized volume of ABHR, handrubbing for 15 seconds was non-inferior to 30 seconds in reducing bacterial load, irrespective of type of bacteria or contamination fluid concentration. This provides further support for a shorter, 15-seconds, hand-hygiene action.


Assuntos
Carga Bacteriana , Desinfetantes/administração & dosagem , Escherichia coli/isolamento & purificação , Desinfecção das Mãos/métodos , Staphylococcus aureus/isolamento & purificação , Álcoois/administração & dosagem , Estudos Cross-Over , Feminino , Mãos/microbiologia , Humanos , Masculino , Distribuição Aleatória , Fatores de Tempo
18.
J Hosp Infect ; 103(3): 321-327, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31226271

RESUMO

BACKGROUND: Hand hygiene compliance even before infection-prone procedures (indication 2, 'before aseptic tasks', according to the World Health Organization (WHO)) remains disappointing. AIM: To improve hand hygiene compliance by implementing gloved hand disinfection as a resource-neutral process optimization strategy. METHODS: We performed a three-phase intervention study on a stem cell transplant ward. After baseline evaluation of hand hygiene compliance (phase 1) gloved hand disinfection was allowed (phase 2) and restricted (phase 3) to evaluate and differentiate intervention derived from learning and time effects. The incidence of severe infections as well as of hospital-acquired multidrug-resistant bacteria was recorded by active surveillance. FINDINGS: Hand hygiene compliance improved significantly from 50% to 76% (P < 0.001) when gloved hand disinfection was allowed. The biggest increase was for infection-prone procedures (WHO 2) from 31% to 65%; P < 0.001. Severe infections decreased by trend (from 6.0 to 2.5 per 1000 patient-days) whereas transmission of multidrug-resistant organisms was not affected. CONCLUSION: Gloved hand disinfection significantly improved compliance with the hand hygiene, especially in activities relevant to infections and infection prevention. Thus, this process optimization may be an additional, easy implementable, resource-neutral tool for a highly vulnerable patient cohort.


Assuntos
Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo/efeitos adversos , Infecção Hospitalar/prevenção & controle , Desinfecção das Mãos/métodos , Controle de Infecções/métodos , Transplante de Células-Tronco/efeitos adversos , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Farmacorresistência Bacteriana Múltipla , Feminino , Fidelidade a Diretrizes , Humanos , Incidência , Masculino
19.
PLoS Med ; 16(6): e1002841, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31242190

RESUMO

BACKGROUND: Helminth and protozoan infections affect more than 1 billion children globally. Improving water quality, sanitation, handwashing, and nutrition could be more sustainable control strategies for parasite infections than mass drug administration, while providing other quality of life benefits. METHODS AND FINDINGS: We enrolled geographic clusters of pregnant women in rural western Kenya into a cluster-randomized controlled trial (ClinicalTrials.gov NCT01704105) that tested 6 interventions: water treatment, improved sanitation, handwashing with soap, combined water treatment, sanitation, and handwashing (WSH), improved nutrition, and combined WSH and nutrition (WSHN). We assessed intervention effects on parasite infections by measuring Ascaris lumbricoides, Trichuris trichiura, hookworm, and Giardia duodenalis among children born to the enrolled pregnant women (index children) and their older siblings. After 2 years of intervention exposure, we collected stool specimens from 9,077 total children aged 2 to 15 years in 622 clusters, including 2,346 children in an active control group (received household visits but no interventions), 1,117 in the water treatment arm, 1,160 in the sanitation arm, 1,141 in the handwashing arm, 1,064 in the WSH arm, 1,072 in the nutrition arm, and 1,177 in the WSHN arm. In the control group, 23% of children were infected with A. lumbricoides, 1% with T. trichiura, 2% with hookworm, and 39% with G. duodenalis. The analysis included 4,928 index children (median age in years: 2) and 4,149 older siblings (median age in years: 5); study households had an average of 5 people, <10% had electricity access, and >90% had dirt floors. Compared to the control group, Ascaris infection prevalence was lower in the water treatment arm (prevalence ratio [PR]: 0.82 [95% CI 0.67, 1.00], p = 0.056), the WSH arm (PR: 0.78 [95% CI 0.63, 0.96], p = 0.021), and the WSHN arm (PR: 0.78 [95% CI 0.64, 0.96], p = 0.017). We did not observe differences in Ascaris infection prevalence between the control group and the arms with the individual interventions sanitation (PR: 0.89 [95% CI 0.73, 1.08], p = 0.228), handwashing (PR: 0.89 [95% CI 0.73, 1.09], p = 0.277), or nutrition (PR: 86 [95% CI 0.71, 1.05], p = 0.148). Integrating nutrition with WSH did not provide additional benefit. Trichuris and hookworm were rarely detected, resulting in imprecise effect estimates. No intervention reduced Giardia. Reanalysis of stool samples by quantitative polymerase chain reaction confirmed the reductions in Ascaris infections measured by microscopy in the WSH and WSHN groups. Trial limitations included imperfect uptake of targeted intervention behaviors, limited power to detect effects on rare parasite infections, and that it was not feasible to blind participants and sample collectors to treatment status. However, lab technicians and data analysts were blinded to treatment status. The trial was funded by the Bill & Melinda Gates Foundation and the United States Agency for International Development. CONCLUSIONS: Integration of improved water quality, sanitation, and handwashing could contribute to sustainable control strategies for Ascaris infections, particularly in similar settings with recent or ongoing deworming programs. Combining nutrition with WSH did not provide further benefits, and water treatment alone was similarly effective to integrated WSH. Our findings provide new evidence that drinking water should be given increased attention as a transmission pathway for Ascaris. TRIAL REGISTRATION: ClinicalTrials.gov NCT01704105.


Assuntos
Giardíase/prevenção & controle , Desinfecção das Mãos/tendências , Avaliação Nutricional , População Rural/tendências , Saneamento/tendências , Purificação da Água , Adolescente , Animais , Criança , Pré-Escolar , Feminino , Giardia , Giardíase/epidemiologia , Giardíase/transmissão , Desinfecção das Mãos/métodos , Helmintos , Humanos , Masculino , Saneamento/métodos , Solo/parasitologia , Resultado do Tratamento , Purificação da Água/métodos
20.
PLoS Negl Trop Dis ; 13(5): e0007323, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31050672

RESUMO

BACKGROUND: Soil transmitted helminths (STH) infect >1.5 billion people. Mass drug administration (MDA) effectively reduces infection; however, there is evidence for rapid reinfection and risk of potential drug resistance. We conducted a randomized controlled trial in Bangladesh (WASH Benefits, NCT01590095) to assess whether water, sanitation, hygiene and nutrition interventions, alone and combined, reduce STH in a setting with ongoing MDA. METHODOLOGY/PRINCIPAL FINDINGS: In 2012-2013, we randomized 720 clusters of 5551 pregnant women into water treatment, sanitation, handwashing, combined water+sanitation+handwashing (WSH), nutrition, nutrition+WSH (N+WSH) or control arms. In 2015-2016, we enrolled 7795 children, aged 2-12 years, of 4102 available women for STH follow-up and collected stool from 7187. We enumerated STH infections with Kato-Katz. We estimated intention-to-treat intervention effects on infection prevalence and intensity. Participants and field staff were not blinded; laboratory technicians and data analysts were blinded. Prevalence among controls was 36.8% for A. lumbricoides, 9.2% for hookworm and 7.5% for T. trichiura. Most infections were low-intensity. Compared to controls, the water intervention reduced hookworm by 31% (prevalence ratio [PR] = 0.69 (0.50,0.95), prevalence difference [PD] = -2.83 (-5.16,-0.50)) but did not affect other STH. Sanitation improvements reduced T. trichiura by 29% (PR = 0.71 (0.52,0.98), PD = -2.17 (-4.03,-0.38)), had a similar borderline effect on hookworm and no effect on A. lumbricoides. Handwashing and nutrition interventions did not reduce any STH. WSH and N+WSH reduced hookworm prevalence by 29-33% (WSH: PR = 0.71 (0.52,0.99), PD = -2.63 (-4.95,-0.31); N+WSH: PR = 0.67 (0.50,0.91), PD = -3.00 (-5.14,-0.85)) and marginally reduced A. lumbricoides. Effects on infection intensity were similar. CONCLUSIONS/SIGNIFICANCE: In a low-intensity infection setting with MDA, we found modest but sustained hookworm reduction from water treatment and combined WSH interventions. Impacts were more pronounced on STH species with short vs. long-term environmental survival. Our findings suggest possible waterborne transmission for hookworm. Water treatment and sanitation improvements can augment MDA to interrupt STH transmission. TRIAL REGISTRATION: NCT01590095.


Assuntos
Água Doce/parasitologia , Desinfecção das Mãos/métodos , Helmintíase/prevenção & controle , Helmintos/isolamento & purificação , Saneamento/métodos , Animais , Bangladesh/epidemiologia , Criança , Pré-Escolar , Dieta , Fezes/parasitologia , Feminino , Helmintíase/epidemiologia , Helmintíase/transmissão , Helmintos/classificação , Helmintos/genética , Humanos , Masculino , Avaliação Nutricional , Gestantes , Solo/parasitologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA