Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water.
Oswald, William E;
Hunter, Gabrielle C;
Lescano, Andres G;
Cabrera, Lilia;
Leontsini, Elli;
Pan, William K;
Soldan, Valerie Paz;
Gilman, Robert H;
(2008)
Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water.
Tropical medicine & international health, 13 (11).
pp. 1421-1428.
ISSN 1360-2276
DOI: https://doi.org/10.1111/j.1365-3156.2008.02177.x
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OBJECTIVE: To document frequency of hygiene practices of mothers and children in a shantytown in Lima, Peru. METHODS: Continuous monitoring over three 12-h sessions in households without in-house water connections to measure: (i) water and soap use of 32 mothers; (ii) frequency of interrupting faecal-hand contamination by washing; and (iii) the time until faecal-hand contamination became a possible transmission event. RESULTS: During 1008 h of observation, 55% (65/119) of mothers' and 69% (37/54) of children's faecal-hand contamination events were not followed within 15 min by handwashing or bathing. Nearly 40% (67/173) of faecal-hand contamination events became possible faecal-oral transmission events. There was no difference in the time-until-transmission between mothers and children (P = 0.43). Potential transmission of faecal material to food or mouth occurred in 64% of cases within 1 h of hand contamination. Mean water usage (6.5 l) was low compared to international disaster relief standards. CONCLUSIONS: We observed low volumes of water usage, inadequate handwashing, and frequent opportunities for faecal contamination and possible transmission in this water-scarce community.