Hand cleaning with ash for reducing the spread of viral and bacterial infections: a rapid review

Funada, Satoshi; Yoshioka, Takashi; Luo, Yan; Sato, Akira; Akamatsu, Shusuke; Watanabe, Norio

doi:10.1002/14651858.cd013571

Cited by 11 publications

(4 citation statements)

References 23 publications

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“…Nevertheless, the WHO Guidelines on Hand Hygiene in Health Care recommend washing hands with clean, running water whenever possible 28. While there are discordant recommendations for the use of ash, there is uncertain evidence whether this stops or reduces the spread of pathogens compared with hand cleansing with soap, mud, soil or no hand cleansing 90. Future guidelines may consider the efficacy of hand hygiene products along with their availability and acceptability in domestic, public and institutional settings to make relevant recommendations, particularly in water-scarce regions or settings where there is limited access to soap or ABHR.…”

Section: Discussionmentioning

confidence: 99%

Recommendations for hand hygiene in community settings: a scoping review of current international guidelines

et al. 2023

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BackgroundHand hygiene is an important measure to prevent disease transmission.ObjectiveTo summarise current international guideline recommendations for hand hygiene in community settings and to assess to what extent they are consistent and evidence based.Eligibility criteriaWe included international guidelines with one or more recommendations on hand hygiene in community settings—categorised as domestic, public or institutional—published by international organisations, in English or French, between 1 January 1990 and 15 November 2021.Data sourcesTo identify relevant guidelines, we searched the WHO Institutional Repository for Information Sharing Database, Google, websites of international organisations, and contacted expert organisations and individuals.Charting methodsRecommendations were mapped to four areas related to hand hygiene: (1) effective hand hygiene; (2) minimum requirements; (3) behaviour change and (4) government measures. Recommendations were assessed for consistency, concordance and whether supported by evidence.ResultsWe identified 51 guidelines containing 923 recommendations published between 1999 and 2021 by multilateral agencies and international non-governmental organisations. Handwashing with soap is consistently recommended as the preferred method for hand hygiene across all community settings. Most guidelines specifically recommend handwashing with plain soap and running water for at least 20 s; single-use paper towels for hand drying; and alcohol-based hand rub (ABHR) as a complement or alternative to handwashing. There are inconsistent and discordant recommendations for water quality for handwashing, affordable and effective alternatives to soap and ABHR, and the design of handwashing stations. There are gaps in recommendations on soap and water quantity, behaviour change approaches and government measures required for effective hand hygiene. Less than 10% of recommendations are supported by any cited evidence.ConclusionWhile current international guidelines consistently recommend handwashing with soap across community settings, there remain gaps in recommendations where clear evidence-based guidance might support more effective policy and investment.

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Section: Discussionmentioning

confidence: 99%

Recommendations for hand hygiene in community settings: a scoping review of current international guidelines

et al. 2023

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“…However, limited resources were again a reoccurring theme for this CC. IPC training in low-resource settings should discuss appropriate low-cost alternatives that still meet minimum standards to avoid potentially harmful reported practices such as hand washing with ash, decontaminating or sterilizing with inappropriate substances or multiuse of single-usage items [33,34]. Water availability was also heavily discussed with multiple participants emphasizing "Water is Life".…”

Section: Discussionmentioning

confidence: 99%

Implementation of the WHO Core Components of an Infection Prevention and Control Programme in two Sub-Saharan African Acute Health-Care Facilities: a Mixed Methods Study

Wood,

Tembele,

Hema

et al. 2023

Preprint

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Background The coronavirus pandemic again highlighted the need for robust health care facility infection prevention and control (IPC) programmes. WHO guidelines on the core components (CCs) of IPC programmes provides guidance for facilities, but their implementation can be difficult to achieve in resource-limited settings. We aimed to gather evidence on an initial WHO IPC implementation experience using a mixed methods approach. Methods A five-day training on the WHO IPC CCs was conducted at two reference acute health care facilities in the Democratic Republic of Congo and Burkina Faso. This was accompanied by a three-part mixed-methods evaluation consisting of a: 1) baseline and follow-up survey of participants’ knowledge, attitudes and practices (KAP), 2) qualitative assessment of plenary discussion transcripts and 3) deployment of the WHO IPC assessment framework (IPCAF) tool. Results were analysed descriptively and with a qualitative inductive thematic approach. Results Twenty-two and twenty-four participants were trained at each facility, respectively. Baseline and follow-up KAP results suggested increases in knowledge related to the necessity of a dedicated IPC focal person and annual evaluations of IPC training although lack of recognition on the importance of including hospital leadership in IPC training and hand hygiene monitoring recommendations remained. Most participants reported rarely attending IPC meetings or participating in IPC action planning although attitudes shifted towards stronger agreement with the feeling of IPC responsibility and importance of an IPC team. A reocurring theme in plenary discussions was related to limited resources as a barrier to IPC implementation, namely lack of reliable water access. However, participants recognised the importance of IPC improvement efforts such as practical IPC training methods or the use of data data to improve quality of care. The facilities’ IPCAF scores reflected a ‘basic/intermediate’ IPC implementation level. Conclusions The training and mixed-methods evaluation revealed initial IPC implementation experiences that could be used to inform stepwise approaches to facility IPC improvement in resource-limited settings. Implementation strategies should consider both global standards such as the WHO IPC CCs and specific local contexts. The early involvement of all relevant stakeholders and parallel efforts to advocate for sufficient resources and health system infrastructure are critical.

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“…Handwashing was defined as handwashing with soap, hand cleaning (with water), or hand disinfection with sanitiser. Handwashing with ash was excluded given that evidence of its effectiveness at removing or killing pathogens is limited [29]. For each parameter and sub-concept Medical Subject Headings (MeSH) terms were used along with other targeted keywords and search terms.…”

Section: Key Definitions Search Terms and Search Strategy For Publish...mentioning

confidence: 99%

Mapping the Association between Mental Health and People’s Perceived and Actual Ability to Practice Hygiene-Related Behaviours in Humanitarian and Pandemic Crises: A Scoping Review

Ghassemi

Thorseth

Roch

et al. 2023

Preprint

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Humanitarian crises such as disease outbreaks, conflict and displacement and natural disasters affect millions of people primarily in low- and middle-income countries. Here, they often reside in areas with poor environmental health conditions leading to an increased burden of infectious diseases such as diarrheal and respiratory infections. Water, sanitation, and hygiene behaviours are critical to prevent such infections and deaths. A scoping review was conducted to map out what is known about the association between three mental health issues and people’s perceived and actual ability to practice hygiene-related behaviours, particularly handwashing, in humanitarian and pandemic crises. Published and grey literature was identified through database searches, humanitarian-relevant portals, and consultations with key stakeholders in the humanitarian sector. 25 publications were included, 21 were peer-reviewed published articles and four were grey literature publications. Most of the studies were conducted in China (n=12) and most were conducted in a pandemic outbreak setting (n=20). Six studies found a positive correlation between handwashing and anxiety where participants with higher rates of anxiety were more likely to practice handwashing with soap. Four studies found an inverse relationship where those with higher rates of anxiety were less likely to wash their hands with soap. The review found mixed results for the association between handwashing and depression, with four of the seven studies reporting those with higher rates of depression were less likely to wash their hands, while the remaining studies found that higher depressions scores resulted in more handwashing. Mixed results were also found between post-traumatic stress disorder (PTSD) and handwashing. Two studies found that lower scores of PTSD were associated with better hygiene practices, including handwashing with soap. The contradictory patterns suggest that researchers and practitioners need to explore this association further, in a wider range of crises, and need to standardize tools to do so.

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Hand cleaning with ash for reducing the spread of viral and bacterial infections: a rapid review

Cited by 11 publications

References 23 publications

Recommendations for hand hygiene in community settings: a scoping review of current international guidelines

Recommendations for hand hygiene in community settings: a scoping review of current international guidelines

Implementation of the WHO Core Components of an Infection Prevention and Control Programme in two Sub-Saharan African Acute Health-Care Facilities: a Mixed Methods Study

Mapping the Association between Mental Health and People’s Perceived and Actual Ability to Practice Hygiene-Related Behaviours in Humanitarian and Pandemic Crises: A Scoping Review

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