Efficacy of Waterless Hand Hygiene Compared with Handwashing with Soap: A Field Study in Dar es Salaam, Tanzania

Effective handwashing with soap requires reliable access to water supplies. However, more than three billion persons do not have household-level access to piped water. This research addresses the challenge of improving hand hygiene within water-constrained environments. The antimicrobial efficacy of alcohol-based hand sanitizer, a waterless hand hygiene product, was evaluated and compared with handwashing with soap and water in field conditions in Dar es Salaam, Tanzania. Hand sanitizer was significantly better than handwashing with respect to reduction in levels of faecal streptococci (P = 0.01). The feasibility and health impacts of promoting hand sanitiser as an alternative hand hygiene option for water-constrained environments should be assessed. Am J Trop Med Hyg. 2010;82(2):270-8.