Effect of washing hands with soap on diarrhoea risk in the community: a systematic review.

This review set out to determine the impact of washing hands on the risk of diarrhoea in the community. Seventeen studies (seven interventions, six case-control, two cross-sectional, and two cohorts) that linked handwashing with diarrhoeal diseases were analysed. Based on the evidence analysed, washing hands with soap could reduce the risk of diarrhoeal diseases by 42–47%. The risks of severe intestinal infections and of shigellosis were associated with reductions of 48% and 59%, respectively. The authors extrapolated that the potential number of diarrhoea deaths that could be prevented by handwashing is about 1 million. They recommend that more and better-designed trials are needed to measure the impact of washing hands on diarrhoea and acute respiratory infections in developing countries. Lancet Infectious Diseases 2003;3:275-281.