ArticleTropical medicine and health2021
Handwashing effect on diarrheal incidence in children under 5 years old in rural eastern Ethiopia: a cluster randomized controlled trial.
Article in Tropical medicine and health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Burden of Childhood Diarrhea and Its Associated Factors in Ethiopia: A Review of Observational Studies.International journal of public health · 2024Pooled it
- Pooled it
- Prevalence and risk factors of diarrhea among young children in Kenya's drylands: A longitudinal study.PLOS global public health · 2026Article
- Household Water Security, Hygienic Handling Practices, and Fecal Contamination: A Mediation Analysis From Wenago District, Gedeo Zone, South Ethiopia.BioMed research international · 2026Article
- Women wash practices and household diarrhea among rural indigenous Kumal community of Nepal: a cross-sectional study.BMC public health · 2025Article
- Global and regional trends in under-five diarrheal disease burden: impact of human development index and geographic disparities, 1990-2021.Gastroenterology and hepatology from bed to bench · 2025Article
- Article
- Handwashing among caregivers of young children in a protracted and complex refugee and immigration context: a mixed methods study on the Thai-Myanmar border.Frontiers in public health · 2023Article
- Improved Water and Waste Management Practices Reduce Diarrhea Risk in Children under Age Five in Rural Tanzania: A Community-Based, Cross-Sectional Analysis.International journal of environmental research and public health · 2022Article
- Trends in handwashing behaviours for COVID-19 prevention: Longitudinal evidence from online surveys in 10 sub-Saharan African countries.PLOS global public health · 2021Article
- Hand-Washing at Critical Times and Associated Factors Among Mothers/Caregivers of Under-Five Year Children in Nefas Silk Lafto Sub-City, Addis Ababa, Ethiopia.Health services research and managerial epidemiologyArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHandwashing with soap reduces diarrheal diseases burden considerably. However, the importance of handwashing in homes has received little attention in rural eastern Ethiopia. The effectiveness of handwashing may be reduced by lack of information on when and in what event hands must be washed, the frequency of handwashing, the individual who should wash his/her hands, and the procedure of handwashing. In these areas, indicators of adherence to handwashing are yet to be established. This study aimed at assessing the efficiency of handwashing on reducing diarrheal disease in children under 5 years old in rural kebeles of Dire Dawa, east Ethiopia.
methodsCommunity-based cluster randomized controlled trial was conducted in rural kebeles of Dire Dawa for 4 months starting from October 2018 to January 2019. Selected clusters were randomized in intervention and control arms using draw method and data collectors conducted the baseline survey. Households assigned to the intervention group were given two bars of plain soap on a bi-monthly basis together with information promoting hand hygiene. Control households were allowed to continue their habitual handwashing practices. We compared the diarrheal incidences of the intervention and non-intervention households. Generalized estimation equations using Poisson family and log choice of the link was employed to calculate adjusted incidence rate ratio with its 95% confidence interval.
resultsWe recorded a significant lesser diarrheal incidence in the handwashing arm than in the non-intervention arm (6.9 versus 13.8 episodes per 100 person weeks of observation). In all, there was a 41% reduction in diarrheal incidence in the intervention arm in relation to the non-intervention arm.
conclusionHandwashing with soap complemented with hand hygiene promotion significantly decreased diarrheal episodes in children under 5 years old in rural kebeles of Dire Dawa. We recommend the promotion and adaptation of washing hands using soap at recommended times to be an effective means of reducing childhood diarrhea morbidity in rural populations of Ethiopia towards achieving the Sustainable Development Goal 6.
trial registrationPACTR, PACTR201807815961394 . Registered 16 July 2018.
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