Effect of handwashing on child health: a randomised controlled trial.

Luby et al. undertook a randomised controlled trial to assess the effect of handwashing promotion with soap on the incidence of acute respiratory infection, impetigo, and diarrhoea in adjoining squatter settlements in Karachi, Pakistan. Fieldworkers visited households weekly for 1 year to encourage handwashing by residents in households and to record symptoms in all households. Children younger than 5 years in households that received plain soap and handwashing promotion had a 50% lower incidence of pneumonia than controls (95% CI –65% to –34%). Also compared with controls, children younger than 15 years in households with plain soap had a 53% lower incidence of diarrhoea (–65% to –41%) and a 34% lower incidence of impetigo (–52% to –16%). Incidence of disease did not differ significantly between households given plain soap compared with those given antibacterial soap containing 1·2% triclocarban. Lancet 2005; 366: 225 – 233.