Handwashing programmes could be intervention of choice for diarrhoeal diseases

Handwashing could prevent more than one million deaths a year from diarrhoeal diseases.

Recent research at the LSHTM has revealed that the simple act of washing your hands can reduce the risk of diarrhoeal diseases by 42-47% and interventions to promote hand washing could save a million lives.

Deaths from diarrhoeal diseases are among the top three killers of children. However, whereas major new initiatives to combat malaria, HIV, and tuberculosis have been announced, interest in research and intervention in the diarrhoeal diseases has waned," they say in their article.

Current evidence suggests, that washing hands and that interventions to encourage hand washing might save a million lives. In the absence of sufficient mortality studies, we extrapolate the potential number of diarrhoea deaths that could be averted by hand washing at about a million," wrote the authors (Lancet Infectious Diseases 2003;3:275-81).

The authors, from the London School of Hygiene and Tropical Medicine, add, "Although more and more rigorous intervention trials of the health impact of hand washing are badly needed, current evidence shows a clear and consistent pattern. If hand washing with soap could save over a million lives, if rates of hand washing are currently very low, and if carefully designed hand washing promotion programmes can be effective and cost-effective, then hand washing promotion may become an intervention of choice."

Although there is much discussion about how to improve handwashing habits in healthcare settings, the importance of handwashing in homes, particularly in developing countries, gets scarce attention.

"Interest in the diarrhoeal diseases peaked in the 1980s with efforts to promote oral rehydration and improved water supply. Today, they are ranked third as cause of death and second as cause of healthy life years lost due to premature mortality and disability.

"Rigorous intervention trials are needed to explore the impact of hand washing on diarrhoea and other infections, in a variety of settings. Basic work is still needed to clarify when hands should be washed, how often, by whom, and in what manner. Simple indicators of hand washing compliance need to be developed and validated.

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