Hand washing with soap
Sixty-two per cent of Africans do not have access to an improved sanitation facility -- a proper toilet -- which separates human waste from human contact, according to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation.
A new systematic review that set out to determine the impact of washing hands with soap in the community worldwide concludes that handwashing could reduce the risk of diarrhoea by up to 47%. On current evidence, washing hands with soap can reduce the risk of diarrhoeal diseases by 42-47% and interventions to promote hand washing might save a million lives. In the absence of adequate mortality studies, we extrapolate the potential number of diarrhoea deaths that could be averted by hand washing at about a million, wrote the authors (Lancet Infectious Diseases 2003;3:275-81). Diarrhoeal diseases are among the top three killers of children, and the authors say that the most recent published estimate of the total annual death rate from diarrhoeal diseases is 2.2 million. The authors say that, although there is much discussion about how to improve handwashing habits in healthcare settings, the importance of handwashing in homes, particularly in developing countries, gets scant attention. Rigorous intervention trials are needed to explore the impact of hand washing on diarrhoea and other infections, in a variety of settings. Basic work is still needed to clarify when hands should be washed, how often, by whom, and in what manner. Simple indicators of hand washing compliance need to be developed and validated, they say. (Source: Abergavenny Roger Dobson, News Extra: BMJ 2003;326:1004 )