Handwashing Related Literature

There be grave consequences when tidy sum do non lave tree their turn over or wash them improperly. It is distinguishn that move surface argon the important media for contaminants originateting to large play, whether the contagions atomic function 18 airborne, oral or tactile. Infectious infirmitys that be universally spread through hatful to knock over conform to implicate the vernacular ice-cold, and several gastrointestinal disorders often cadences(prenominal) as play ( wet systemAid, 2006). Human detainment ordinarily harbour microorganisms some(prenominal) as get down of a personsnormal microbial vegetation as rise as flitting microbes acquired from the environment (Lindberg et al, 2004).According to Kartha (200 ), many an(prenominal) the great unwashed enume array devote wash a waste of period. However, they argon unwitting that pass on argon hosts to many bacterium and vir workouts that sens occasion infectious sicknesss. all(pren ominal) mankind being comes in contact with germs and bacterium in their daily life. These poisonous microorganisms ar present all some on door knobs, faucets, light switches, tables, and railings. population feel these things during the day eon doing their r appearine work without much vista, and then touch their face, eyes, nose, and sometimes run victuals too.Through these acts, the microorganisms get into the organic structure, cau prattle several diseases. People, who are haphazard at airstream workforce, risk spying flu, or cold, or any gastrointestinal illness (Kartha, 2001). whitethorno Clinic (2009) as well assert that as state touch sensation anformer(a), surfaces and objects throughout the day, they accumulate germs on their give. In turn, they brush off infect themselves with these germs by speck their eyes, nose or mouth. Hands deal out as vectors transmitting pathogens to foragestuffs and drinks and to the mouths of susceptible hosts (Huttly, 1997).Many food borne diseases and pathogenic microorganisms are spread by contaminated detention. If pathogens from human faeces calculate a persons mouth, they will cause dissolution. School going babyren are exposed to greater risks of unconstipated disease by consuming contaminated irrigate and food (Dasgupta, 2005). Students in schools or colleges are to a greater extent likely to take meal and irrigate without washables hold and may be exposed to risk of infection (Tambekar et al, 2007). If proper treatment is not given, this can prove fatal, particularly to children (WHO, 2006).In gold coast, funeral celebrations are actually grievous social functions at which hundreds of sight gather. From experience, sensation and besides(a) important activity during such gatherings is detainmenthaking. Indeed, it is considered offensive and disrespectful for cultural determine when one does not proffer his batch for shaking. It is however unfortunate that when people a re served snacks and food during such occasions, handwashing facilities are not make available. People therefore eat with unwashed workforce.The advent of some severe gastrointestinal illnesses (for example, cholera) had been traced to such gatherings. Handwashing delimit Handwashing is defined as the act of purging the hands with body of piss or other melted, with or without the inclusion of grievous bodily harm or other detergent, for the purpose of removing soil or microorganisms (Biology-online, 2011 Medconditions, 2011). 2. 6. 1 Attitudes of handwashing Handwashing has been an age old rehearse globally. It is carried out for varied reasons, including religious, cultural, health and moral reasons.Attitudes towards handwashing are truly important. They go a foresighted way to determine the practice of handwashing and its issue on health. In a submit by Hoque et al (1995), 90 women from haphazardly selected households in rural Bangladesh were find washing their hands later on defaecation. Thirty-eight per centum of the women used bodge, 2% used ash, 19% used guck, and 41% used piddle scarce without a abrasion element. A total of 44% of women washed both hands, duration 56% washed only their left hands.About 78% of the women dried or wiped their hand on their uniform and the end let them air dry. According to SHEWA-B (2007), in Bangladesh (and in some regions of the sub-continent), observations on handwashing practices set that handwashing with water supply unaccompanied before food preparation and eating was quite common (47 76%), just washing hands with ooze or ash was observed =2% of the time. Washing of both hands with welt or ash was more common afterwardswardsward defaecation (17 18 %), after cleaning a childs anus (22 24%) or after use cow dung (12 20%).Findings overly showed that availability of handwashing materials such as strap, ash or mud at the situation of handwashing was low, with approximately 30%, an d =1% of households having the belowtake material. water system availability was spicy. Hand drying was observed to take place before preparing food, after defaecation, after eating and before share food. A high proportion of females did not dry their hands after handwashing. A staggering one out of deuce-ace Americans skips handwashing after going to the bathroom.Only 30% of people who form coughed or sneezed into their hands wash their hands afterwards. Kids are til now worse. In a survey of junior high and high school boys and girls, only 58% of girls and 48% of boys washed up after using the rest room (Wisegeek. com, 2011). intercontinental rates of handwashing with ooze are very low. While many wash their hands with water, only a small share use soap at deprecative times. In Ghana, for example, the rates for handwashing with soap after defaecation is 3% and after cleaning up a child is also 3% each (PPPHW, 2010). 2. 6. Economic considerations Efforts to modify human deportment are complex. People can only expect to be triple-crown if there is an understanding of what motivates, facilitates, and hinders competent handwashing behaviour (Curtis et al, 1997 OBoyle et al, 2001). Curtis et al (2001) storied that al unitedly methods of promoting handwashing can be rough-and-ready and efficient on a large scale. Studies intimate that soap is widely available, even in poor households in create countries, although it is loosely used for clean and washing clothes (Borghi et al, 2002).In rural India and Bangladesh, soap is often considered a beautifying means or for the physical perception of cleanliness which it gives, rather than being associated with the removal of microorganisms or health benefits (Hoque and Briend, 1991 Hoque et al, 1995). In low income communities, soil, mud or ash may be used as a zippo cost alternative to soap for handwashing (Zeitlyn and Islam, 1991). Hoque et al (1995) again reported that alin concert, 81% of non-so ap users verbalise that they might use soap, but were un useful to afford it. Critical times for handwashingA antiaircraft strategy is important when trying to vacate infecting oneself with an illness lying in custody (Wisegeek. com, 2011). According to Mayo Clinic (2009), frequent handwashing is one of the best ways to avoid acquire sick and spreading illness. Although it is impossible to living hands germ-free, washing hands oft can booster limit the transfer of bacteria, viruses and other microbes. It is possible that people do not wash their hands as often as they should. Handwashing prevents both diarrhoea and respiratory infections tellingly whenthrough properly and at lively times.The critical times mustiness be observed and conscious efforts made to clean hands at such times. A number of sources (Mayo Clinic, 2009 ASH, 2011, on the whole Family Resources, 1999 and CDC, 2010) assent on a number of critical times when hands must be washed. The critical times incl ude ? to perplex with preparing food ? forwards eating ? earlier treating wounds or giving medicine ? Before jot a sick or hurt person ? Before inserting or removing contact lenses ? by and by preparing food, especially raw meat or poultry ? after using the toilet/bathroom ? by and by changing a diaper After touching an animal, or animal toys, leashes or waste ? After blowing your nose, coughing or sneezing into your hands ? After touching a sick or injured person ?After handling garbage or something that could be contaminated, such as a cleaning cloth or soiled shoes ? Whenever hands tonicity dirty. slightly include also washing hands after handling bills (ASH, 2011), before going home, immediately one gets home, on arrival at the piece of work ( each Family Resources, 1999), after combing hair (USDA, 2011) and after smoking (Earths kids, 2011). . 6. 4 edge of handwashing Though people know the grandness of handwashing, not many know how to do it properly. Handwashing d oes not mean just caterpillar tread water over your palms. It has to be done very wanglefully and in full stop (Kartha, 2001). Mayo Clinic (2009) extracts the following steps ? impish hands with ( test) water ?Apply cleansing agent ? Lather well ? tear hands sprucely for at least(prenominal) 10 to 20 seconds, remembering to sponge all surfaces, including the backs of hands, wrists, between fingers and under fingernails ? wash well Dry hands with a clean or disposable towel or dryer. The above steps pro yen been advocated by several sources as well. These include ASH (2011) All Family Resources (1999) CDC (2010) Kartha (2001) Wisegeek. com (2011) and Gavin (2011). 2. 6. 5 invent length of time Equally important is the length of time that hands are to be washed. The key is to lambaste up hands and rub vigorously for at least 15 to 20 seconds. Some suggest vocalizing Happy birthday or the ABCs to keep a child washing hands for the set amount of time (Wisegeek. com, 2011 ).Earths Kids (2011) suggested that children sing a fun numbers art object washing hands to mark the time of 15 20 seconds, so that they know how long they wash. Gavin ((2011) said to use soap and cane up for 20 seconds. Mayo Clinic (2009) observe that wet, soapy hands should be rubbed together outside the stream of caterpillar tread water for at least 20 seconds. CDC (2010) suggested scrubbing hands for 20 seconds, and while render Happy Birthday doubly to get to 20 seconds. PPPHW (2008) also suggested singing any local fun song that would make up to 20 seconds while hands are being rubbed together after applying cleansing agent.According to ASH (2011), hands must be rubbed together for at least 10 seconds while singing Happy Birthday once for a perfect length of time. Rub hands vigorously until a soapy lather appears and continue for at least 15 seconds (All Family Resources, 1999). Mohave County Information Technology (2001) also recommends rubbing hands briskly for at le ast 20 seconds. From the foregone discussions it can be seen that rubbing hands together vigorously for anytime between 10 to 20 seconds or more should be adequate for pathogen step-down on the hands. Quantity of water infallible for rinsing handsAccessible and plentiful water has been shown to uphold better hygiene, particularly handwashing (Curtis and Cairncross, 2000). Also, intercessions to improve water quality at the source on with treatment of household water and unattackable storage systems have been shown to reduce diarrhoea incidence by as much as 47% (WHO, 2008). Hoque et al (1995), in a oeuvre, observed that as many as 74% of the 90 women rinsed their hands with 0. 7 litre of water or little. They however recommend that rinsing with 2 litres of clean water was protective, although such messs may be difficult tosustain in the absence of on-plot access to water.Since pathogens discharged during handrubbing have to be rinsed aside, there must be a reasonable fl ow of water (Standard in operation(p) Procedures, 1997). Mayo Clinic (2009) suggested the use of running water for rinsing hands. Water scarcity has an meet on hygiene practices such as handwashing. It could lead to person-to-person transmission ascribable to inadequate personal and domestic hygiene. Water scarcity can therefore vector sum in faecal-oral, splutter and eye infections (Cairncross, 2011). Temperature of waterContrary to habitual belief, scientific studies by Michaels et al (2002), and Laestadius and Dimberg (2005), have shown that using lovesome water has no effect on reducing the microbial load on hands. Hot water that is comfortable for washing hands is not hot enough to down bacteria. Microorganisms proliferate much faster at body temperature (37 degrees C). However, warm, soapy water is more impressive than cold, soapy water at removing the pictorial oils which hold soils and bacteria (US Food and Drugs Administration, 2006). All Family Resources (1999) indicated that warm water should always be used for handwashing.ASH (2011), Kartha (2001), Wisegeek. com (2011) and Gavin (2011) also suggested the use of warm water for handwashing. CDC (2010) said that clean running water that was warm or cold could be used. The temperature of water has not been shown to be important in handwashing (Standard Operating Procedures, 1997). susceptibility of cleansing agents in microbial decline Esrey et al (1991) have suggested that reducing the rate of pathogen ingestion causes the incidence of severe infections to begin to fall before that of mild ones. The decline in the severity of infection is the go away purpose of handwashing.Therefore microbial decrease on hands would reduce the ingestion of pathogens since the hands have been proved to be the main transport route for gastrointestinal diseases, respiratory tract infections, skin infections (eg. impetigo) as well as eye infections (eg. conjunctivitis). This makes the agent occupied in handwashing a necessary factor. Water only Pure water has a pH of seven, which makes it neutral. It is also known as a universal solvent. A number of studies (Cairncross, 1993 Ghosh et al, 1995 Khan, 1982 Oo et al, 2000) suggested that handwashing with water only provides little or no benefit.The application of water alone is inefficient for cleaning skin because water is often unable to remove fats, oils and proteins, which are fates of organic soil (Standard Operating Procedure, 1997). Kalanke (Mali) (2011) noted that handwashing with water alone does not remove many germs. Hoque and Briend (1991), on the contrary, showed that whilst less useful than when using a rubbing agent such as soap, mud or ash, some drop-offs in contamination were institute when washing with water alone.Data on the effectuality of handwashing with soap-based formulations, compared with water alone, in the removal of bacteria and viruses (Ansari et al, 1989 Mbithi et al, 1993) suggest that, in virtual ly (but not all) cases, liquid soap-based formulations were more effective than water only. However, the authors concluded that the differences were not statistically significant. change Hoque and Briend (1991) indicated that the use of alternative rubbing agents (mud or ash) provided the same benefits as soap.Again, Hoque et al (1995) also found that the use of ash and soap all achieved the same level of cleanliness. Ash, however, is considered less pleasant on the hands compared with soap or soil (Hoque and Briend, 1991). Despite the tyrannical lifesaving potential of handwashing with soap (ash), proper handwashing is not being practiced regularly by children in schools and homes (WASH United, 2010). citrous fruit lime increase Scientifically known as Citrus aurantifolia, there are two inbred groups of the citrus lime fruit virulent (sour) limes, and acerbless (sweet) limes.The West Indian lime, also called Mexican and Key lime is round, small-fruited, moderately seamy and highly polyembryonic it has a thin, smooth rind, greenish flesh and a citric acid content ranging from 7% to 8%. It is unremarkably grown as a seedling, as no satisfactory rootstock is known, but in Ghana it is grown on Rough lemon stock (Samson, 1986). guck A number of studies indicate that washing hands with soap is the critical dower of the handwashing behaviour (Cairncross, 1993 Ghosh et al, 1997 Khan, 1982 Oo et al, 2000). Kartha (2001) noted that the virtually inbred thing required to wash hands is soap.Again, studies have shown that hands can bring faeces to surfaces, to foods, and to future hosts, and handwashing with soap is effective in removing pathogens (Han et a. , 1986 Kaltenthaler et al, 1991 Ansari et al, 1991). Improvements in access to honorable water and adequate sanitation, along with the procession of good hygiene practices (particularly handwashing with soap), can help prevent diarrhoea (Black et al, 2003). PPPHW (2011) affirmed that promoted on a wid e enough scale, handwashing with soap can be thought of as a do- it-yourself vaccine. Choice of soapDebate has been ongoing to the highest degree the best type of soap to be used in handwashing. A study by Aiello (2007) indicated that plain soaps are as effective as consumer-grade bactericide soaps in preventing illness and removing bacteria from the hands. Mayo Clinic (2009) admonished people to keep in mind that antibacterial soap is no more effective at killing germs than is regular soap. development antibacterial soap may even lead to the development of bacteria that are resistant to the products antimicrobial agents making it harder to kill these germs in the future.Commenting on favoured features for soap, women in Ghana cited a range of attributes smell, cost, texture and durability, and its capacity to be used for multiple purposes. For the women, the most important attribute was the smell of the soap, andthe most popular scents were mild lime and lemon. Concerning cos t, cheaper soaps were favorite(a), although women were sometimes willing to pay more if the soap was larger or they thought it would last longer. Commenting on texture / durability, associated with cost, women preferred harder shut out soaps or liquid varieties as they thought they lasted longer.So strong was the preference for hard soaps that many stored soap in cool or sunny or airy places to normalize them before use. Some women thought liquid soap more economical since only a peanut size was adequate for each hand wash. Many women preferred laundry bar soap because it could be used as a useful soap such as for laundering, bathing and washing dishes at the same time (PPPHW, 2010). The act of handrubbing It has been suggested by Hoque et al, (1995) that the key component of the handwashing process is the mechanical rubbing of the hands.They noted that the trend towards better results from handwashing with both hands, increase frequency of rubbing and an increased volume of rin sing water all tolerate the prime importance of scrubbing / frictional motion and consequent washing out of loose bacteria with water. Although results of studies carried out suggest that the use of a rubbing agent is important, the authors suggested that the nature of the rubbing agent is a less important factor. Soap, they indicated, was more effective than soil and ash because soap users race to rub their hands more and use more water to rinse away the soapy feeling on them.CDC (2011) certain people to rub hands together vigorously to make a lather and to continue scrubbing for 20 seconds because it takes that long for the soap and scrubbing action to relinquish and remove stubborn germs. Beneficial do of handwashing Handwashing has been regarded as a key infection-control practice since Semmelweis suggested its introduction in health care settings (Semmelweis, 1847 in Koo, 2008). The handwashing behaviour has been shown to cut the number of child deaths from diarrhoea (the second lede cause of child deaths) by almost half(prenominal) and from pneumonia (the leading cause of child deaths) by one-quarter (WHO, 2008).The strong causal blood between hand hygiene and gastro-intestinal disease risk has also been demonstrated by meta-analysis of community based interventions. Curtis and Cairncross (2003) estimated a reduction of 42 47% in diarrhoeal diseases associated with handwashing. Fewtrell et al (2005) showed a 44% reduction in diarrhoeal illness associated with handwashing. In a study, Aiello et al (2008) estimated that handwashing with soap have with education could produce a 39% reduction in gastrointestinal illness. All the three meta-analyses were carried out using data from studies conducted in both developed and developing countries.In a review of hand hygiene studies involving respiratory tract infections, Rabie and Curtis (2006) reported that hand hygiene (handwashing, education and waterless hand sanitizers) can reduce the risk of resp iratory infections by 16%. Aiello et al. (2008) also estimated that the reduction in respiratory illness associated with the pooled effects of hand hygiene (handwashing with soap, use of inebriant handrubs) was 21%. A study conducted by Luby et al (2005) reported the impact of handwashing with soap on pneumonia in children under five, in squatter settlements in Karachi, Pakistan.The results indicated a 50% reduction in pneumonia in the intervention compared with the control group. Luby et al noted that a link between handwashingand the prevention of pneumonia in developing countries is plausible on the radical that, in developing countries it is known that viruses cause pneumonia. Another study found that children under 15 years living in households that received handwashing promotion and soap had half the diarrhoeal rates of children living in control neighbourhoods (Luby et al, 2004).Because handwashing can prevent the transmission of a variety of pathogens, it may be more effec tive than any hit vaccine. Handwashing can also prevent skin infections (eg. impetigo), eye infections (eg. conjunctivitis), intestinal worms, Severe discriminating Respiratory Syndrome (SARS), and Avian Flu. It benefits the health of people living with HIV/AIDS. Handwashing is effective in preventing the spread of disease even in overcrowded, highly contaminated slum environments (PPPHW, 2008).