Evaluation of quality and antimicrobial efficacy of locally manufactured alcohol-based hand sanitizers marketed in Addis Ababa, Ethiopia in the era of COVID-19

Abstract

Background The coronavirus disease 2019 (COVID-19) has been rapidly spreading across the globe since the World Health Organization (WHO) has declared the disease outbreak as a global pandemic on March 11, 2020. Hand hygiene, via either regular handwashing with soap and water or using hand sanitizers, is among the various measures that need to be followed to control the outbreak of the disease. Alcohol-based hand sanitizers (ABHS) are the “gold standard” for hand disinfection because of their broad antimicrobial spectrum of activity, easy availability, better safety profile, and general acceptability to users. This study aimed at evaluating the physicochemical quality and antimicrobial efficacy of the locally manufactured ABHS marketed in Addis Ababa, Ethiopia. Methods A cross-sectional survey was used to collect ABHS from Addis Ababa marketplaces. A total of 25 sample products were randomly selected from different categories of hand sanitizer manufacturers. The physicochemical evaluation of the products was carried out as per the United States Pharmacopoeia and WHO standards. Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella spp., and Shigella spp clinical isolates were used for the antimicrobial efficacy test. Results The Fourier Transform Infrared result confirmed that all the test products met the identification test for ethanol. The majority (68%) of ABHS complied with the test for ethanol content (75–85% v/v). However, only 3 products fulfilled the hydrogen peroxide content (0.112–0.137% v/v). LPC307 showed the maximum zone of inhibition of 12 mm against Escherichia coli whereas MPC204 exhibited only 3 mm. LPC101 was found to be more sensitive to Shigella and Klebsiella Spp with minimum inhibitory concentration values of 20% and 10%, respectively. The sample product LPC101 showed a minimum bactericidal concentration of 20% against Escherichia coli, Pseudomonas aeruginosa, and Klebsiella spp. Conclusion One-third of the tested ABHS did not comply with the WHO ethanol content limit and the majority of the products failed to meet the label claim for hydrogen peroxide content. Besides, nearly all products proved that they have activity against all the tested pathogenic microorganisms at a minimum concentration from 10 to 80%; though, they did not show 99.9% bacteriostatic or bactericidal activities as claimed. The study findings suggested regular monitoring of the quality of marketed ABHS considering the current wide use of these products.

Use of Hand Sanitizers in COVID-19 Prevention: A Comprehensive Overview

“…A similar study was performed in Ethiopia recently to analyze the quality and efficacy of local brands of hand sanitizers. The results of this study revealed that over one-third of the analyzed hand sanitizers failed to comply with the guidelines of WHO with respect to the limit of ethanol and hydrogen peroxide in the formulation [48]. Similar results were also obtained in a study conducted on marketed hand sanitizers in Kenya.…”

Sustainable Antioxidant Production for Hygienic Disinfection Using Bioextractants from Lavender and Oregano Distillation Process

“…It should be noted that it was beyond the scope of the current study to carry out sophisticated experimentation in order to further evaluate to which extent the antibacterial properties of these disinfectants are attributed to the inclusion of the essential oils. It has been shown earlier that ethanol, as a chemical substance, is capable of inactivating Staphylococcus aureus and Pseudomonas aeruginosa when used as such or as a substance in alcohol-based hand sanitizers [68,69].…”

Analysis of ethanol content in commercially available Hand sanitizers in Oman using Gas Chromatography- A comparative study

“…However, the level of acidity isn't high enough to cause severe skin irritation, making these products acceptable to the general public. The near neutrality of these hand sanitizers is imperative to the efficacy and acceptability in the market (Selam et al, 2022).…”

“…Because the effectiveness of alcohol-based hand sanitizers depends on the ethanol or isopropanol content, the CDC recommends the use of alcohol-based hand sanitizers greater than 60% ethanol or 70% isopropanol as the preferred form of hand hygiene, whereas the WHO recommends the strength of 80% ethanol or 75% isopropanol as standard for hand hygiene care. However, the quality and safety of commercially available hand sanitizers is a major concern for the regulatory authorities because many studies reported that the ethanol content of hand sanitizers in tested samples varies both within and between countries (Selam, 2020;Selam et al, 2022).…”