Faecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water supply and sanitation activities on faeco-oral disease transmission. I. A case study in rural north-east Thailand

Abstract

Faecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water supply and sanitation activities on faeco-oral disease transmission. I. A case study in rural north-east Thailand J. V. PINFOLD Department of Civil Engineering, University of Leeds, Leeds LS2 9JT, England (Accepted 25 May 1990) SUMMARYMost villagers in north-east Thailand carry water to their homes and store it in separate containers depending on its subsequent use. In one village, information on water use was collated with the bacteriological quality of stored water, water sources and fingertip-rinses. Stored water quality was a function of water-related activities rather than quality at source (P < 0O0001). Specifically water used for toilet, washing dishes and cooking-related activities was much more contaminated with faecal bacteria than that used for drinking and cooking. Salmonella spp. was significantly more common in water used for washing dishes than drinking (P < 005). Escherichia coli contamination of fingertip-rinses was strongly associated with the individual's activity prior to testing (P < 0-0001); child care, food and water-related activities produced much higher levels of fingertip contamination than others. Dirty utensils used for cooking and eating were usually left to soak and faecal bacterial growth occurred in this grossly contaminated soak-water. Cross-contamination via water handling was the main mechanism of stored water pollution. These results were used to develop a hygiene intervention study presented in a companion paper.

Variability in Hand Contamination Based on Serial Measurements: Implications for Assessment of Hand-Cleansing Behavior and Disease Risk

“…Ambient humidity has been shown to be correlated with fingertip contamination. 8 Among persons who do wash hands with soap, the duration of wash time with soap and the volume of soap used for handwashing may also impact the level of hand contamination detected. 17 Of course, factors related to the sample collection and the microbiological tests themselves, including the inconsistency in rigor and technique of rinsing the respondent's hands during sample collection, the methodology used to count the number of organisms or colonies of organisms, and the consistency in the media and other materials, may be responsible for variability in the levels of hand contamination detected.…”

“…4,5 Hand-contamination measurement seems promising as a proxy method for measuring handwashing behavior, because persons specifically instructed to wash hands with a cleansing agent have been shown to have substantially fewer fecal bacteria contaminating their hands compared with people who have not washed hands with a cleansing agent. [6][7][8] Some studies have shown a correlation between reduced hand contamination and reduced diarrhea risk. [9][10][11] However, measured hand contamination can vary based on a number of factors, including the type of sampling and the microbial quantitation methods used, 10 the subject's skin characteristics, 12 humidity, 8 and hygiene behaviors temporally related to the hand-contamination measurement.…”

“…[6][7][8] Some studies have shown a correlation between reduced hand contamination and reduced diarrhea risk. [9][10][11] However, measured hand contamination can vary based on a number of factors, including the type of sampling and the microbial quantitation methods used, 10 the subject's skin characteristics, 12 humidity, 8 and hygiene behaviors temporally related to the hand-contamination measurement. 6 Presumably, the dose of pathogens on hands at critical events impacts the degree to which pathogens are actually transmitted, at those times, from hands to other hands, mouths, or food or water vehicles.…”

Impactos na saúde das deficiências de acesso a água

“…Outro aspecto observado é a imersão desses utensílios com as próprias mãos, o que compromete a qualidade da água de consumo, pois a parte inferior das unhas pode albergar microrganismos patogênicos. Há relatos da presença de bactérias, como Escherichia coli ETEC (enterotoxicogênica), e evidências de contaminação fecal nas unhas de donas-de-casa (Pinfold 1990;Trevett e col., 2005).…”

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

“…[25][26][27][28] These and other previous studies have used the quantitative measurement of fecal indicator bacteria (FIB), such as fecal coliforms, fecal streptococci, and E. coli , on hands to evaluate hand hygiene. [29][30][31] These organisms are not pathogens, but are used to indicate fecal contamination. Further work is needed to determine the relationship between the presence of these indicators on hands, hand hygiene behavior, and health.…”