Effect of intensive handwashing program on childhood diarrhoea in high risk communities in Pakistan.

The study was conducted among 36 neighbourhoods in urban squatter settlements in Karachi, Pakistan. Field workers visited households weekly for 1 year to provide education to all household members old enough to understand about proper handwashing with soap after defecation and before preparing food, eating, and feeding a child. They used slide shows, videotapes, and pamphlets to illustrate health problems resulting from contaminated hands. In the study 300 households (1,523 children) received antibacterial soap (containing triclorocarban, TCC) and 300 households (1,640 children) received plain soap. The results clearly document the public health benefits of hand washing with soap (i.e., ~50% reduction in the incidences of diarrhoea), although the authors failed to find any difference in efficacy between the antibac and non-antibac soap groups. This was perhaps not surprising, since TCC is not effective against the gram negative and other organisms responsible for most forms of diarrhoea. The antibacterial versus.non-antibacterial comparison was only expected to be significant in relation to efficacy against e.g impetigo. Journal of the American Medical Association 2004, 291, 2547-54.