Abstract
Background Worldwide, hand hygiene related diseases such as diarrhoea and upper respiratory diseases are still reported as a leading cause of death in children under 5 years. Washing hands with soap and water can be considered key to reducing the burden of hand hygiene (HH) related diseases and in so doing can contribute towards improved health in children under five years of age. At the time of the study, hand washing with soap at critical times was still only practiced by 19.0% of people worldwide. The need for water, sanitation and hygiene (WASH) interventions to reduce HH-related diseases has shown to be key in all sectors of the community, be it at a household level, at preschools and schools or in health care settings. These WASH interventions can include supply of infrastructure, provision of the necessary equipment, improved water and sanitation or simple education programmes to encourage communities to wash their hands at critical times. Preschoolers can benefit from HH interventions by reducing the burden of disease and absenteeism. Many school hours are lost due to illness and absenteeism which are counterproductive towards reaching the developmental milestones essential at a young age, to produce a child who can participate actively and productively in later school years. This study made use of a simple, cost-effective and entertaining intervention aimed at parents, preschoolers and their caregivers or teachers in order to determine a reduction of HH-related diseases in preschool children. Methods This study was a controlled intervention study conducted at randomly selected preschools in Ekurhuleni, Gauteng. The schools were randomly placed into an intervention group (IG) and a control group (CG). Data was collected pre- and post-intervention from parents, caregivers and preschool children. Data collection tools included questionnaires for parents and caregivers, observations of HH opportunities in the classroom, hygiene inspections of the preschools and the recording of children’s illnesses by caregivers in a symptom register. Hand ““bag-wash”” samples were collected pre-intervention; post-intervention pre- hand wash and post-intervention post-hand wash. The analysis of the “bag-wash” samples was run in an approved laboratory using strict microbiological specifications. A pilot study was conducted in preschools not included in the main study in order to test the effectiveness of the data collection tools and intervention process. The necessary adjustments were made to the data collection tools and intervention prior to the start of the main study. The intervention was administered to IG preschools and included interactive, entertaining learning activities for the children and electronic messages sent to parents and caregivers. The intervention was conducted using a cost-effective “Magic Box” and GloGerm®. Children were taught to wash hands according to the World Health Organization (WHO) approved method and were then able to see if hands had been wash effectively...
D.Tech. (Environmental Health)