SynthesisInternational journal of epidemiology2019
Handwashing with soap after potential faecal contact: global, regional and country estimates.
Synthesis in International journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Evaluating effectiveness of protective interventions towards environmental contamination among under-five children: systematic review and meta-analysis in Africa.BMC public health · 2026Pooled it
- Cost-effectiveness and benefit-cost analyses of promoting handwashing with soap: A systematic review.PLoS medicine · 2026Pooled it
- Minimum material requirements for hand hygiene in community settings: a systematic review.BMJ global health · 2025Pooled it
- Orally Ingested Probiotic, Prebiotic, and Synbiotic Interventions as Countermeasures for Gastrointestinal Tract Infections in Nonelderly Adults: A Systematic Review and Meta-Analysis.Advances in nutrition (Bethesda, Md.) · 2023Pooled it
- Household determinants of observed handwashing among primary schoolchildren in Hebron, Palestine: a cross-sectional study.BMJ open · 2026Trial
- Assessing the Impact of a Handwashing Knowledge and Practices Program among Poor Households in Rural Bangladesh: A Cluster-Randomized Pre-Post Study.The American journal of tropical medicine and hygiene · 2023Trial
- Article
- Impact of hand hygiene on infection-related symptoms in school-aged children: a cross-sectional study on the moderating effect of depression.BMC pediatrics · 2026Article
- Can improved handwashing infrastructure and soap change behavior? findings from a randomized control study in the Dadaab refugee camp in Kenya.Conflict and health · 2026Article
- Household water, sanitation, and hygiene practices in Ghana from 1993-2022: a non-linear multivariate Poisson decomposition and traditional predictive modelling approach.Frontiers in public health · 2026Article
- Prevalence and factors associated with poor hand hygiene practices among adult carers of children under five in Mbale district Uganda.Scientific reports · 2025Article
- Water, Sanitation, and Hygiene for Everyone Intervention Study: Protocol for a Controlled Before-and-After Trial.JMIR research protocols · 2025Article
- Self-reported frequency of handwashing among pet and non-pet owners in different situations: results of four surveys of the general adult population in Germany.BMC public health · 2024Article
- The determinants of handwashing in humanitarian crisis setting during the COVID-19 pandemic: a multi-country analysis.Health promotion international · 2024Article
- Article
- Article
- Exploring toilet plume bioaerosol exposure dynamics in public toilets using a Design of Experiments approach.Scientific reports · 2024Article
- Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study.BMC infectious diseases · 2024Article
- Using Wash'Em to Design Handwashing Programmes for Crisis-Affected Populations in Zimbabwe: A Process Evaluation.International journal of environmental research and public health · 2024Article
- Determinants of Handwashing at Critical Times Among Mothers/Caregivers of Children Under-Five Years Old: Panel Data Evidence From Rural Afghanistan.Environmental health insights · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundLimited data have been available on the global practice of handwashing with soap (HWWS). To better appreciate global HWWS frequency, which plays a role in disease transmission, our objectives were to: (i) quantify the presence of designated handwashing facilities; (ii) assess the association between handwashing facility presence and observed HWWS; and (iii) derive country, regional and global HWWS estimates after potential faecal contact.
methodsFirst, using data from national surveys, we applied multilevel linear modelling to estimate national handwashing facility presence. Second, using multilevel Poisson modelling on datasets including both handwashing facility presence and observed HWWS after potential faecal contact, we estimated HWWS prevalence conditional on handwashing facility presence by region. For high-income countries, we used meta-analysis to pool handwashing prevalence of studies identified through a systematic review. Third, from the modelled handwashing facility presence and estimated HWWS prevalence conditional on the presence of a handwashing facility, we estimated handwashing practice at country, regional and global levels.
resultsFirst, approximately one in four persons did not have a designated handwashing facility in 2015, based on 115 data points for 77 countries. Second the prevalence ratio between HWWS when a designated facility was present compared with when it was absent was 1.99 (1.66, 2.39) P <0.001 for low- and middle-income countries, based on nine datasets. Third, we estimate that in 2015, 26.2% (23.1%, 29.6%) of potential faecal contacts were followed by HWWS.
conclusionsMany people lack a designated handwashing facility, but even among those with access, HWWS is poorly practised. People with access to designated handwashing facilities are about twice as likely to wash their hands with soap after potential faecal contact as people who lack a facility. Estimates are based on limited data.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.