Effect of Intensive Handwashing Promotion on Childhood Diarrhea in High-Risk Communities in Pakistan: A Randomized Controlled Trial.

Examined whether promoting washing hands with antibacterial or plain soap decreased diarrhea among children (under 15 yrs old) at the highest risk of death from diarrhea in Karachi squatter settlements. Method used was the Karachi Soap Health Study that evaluated multiethnic households in Bilal, Hazara, Manzoor, and Mujahid, Karachi, in collaboration with Health Oriented Preventive Education, a nongovernmental organization that operates local health clinics and supports community-based health and development. Most residents in these communities have household toilets but the discharge flows into open sewers. After defecation, toilet paper is rarely used. The water used for drinking and handwashing in these communities is heavily contaminated with fecal organisms. Field workers conducted neighborhood meetings about handwashing. They supplied the families with soap as needed. They visited paerticipating households at least weekly and asked the mother or other caregiver if the children had diarrhea. Results show that during 51 weeks of followup, prevalence of diarrhea was lower among younger children (aged 1-5 yrs) vs older children (aged 5-15 yrs).