Associations among handwashing indicators, wealth, and symptoms of childhood respiratory illness in urban Bangladesh.

Full Abstract

OBJECTIVES:
To explore the relationship of easy to collect handwashing indicators with socioeconomic status and reported respiratory disease among children <5 years of age.

METHODS:
We added several handwashing indicators to a population-based, cross-sectional study of respiratory illness in Dhaka, Bangladesh. We constructed a wealth index using 12 household characteristics analysed with principal component analysis to assess socioeconomic status.

RESULTS:
Of 6970 households, 92% had a bar of body soap, 41% had a place with water to wash hands inside the house, and 40% had soap present at the most convenient place to wash hands. Handwashing indicators were more common among households with higher socioeconomic status. Within each wealth quintile a place to wash hands within the household was strongly associated with the presence of soap at the handwashing location (odds ratios 13-70). In general estimated equation models that controlled for socioeconomic status, the presence of a place inside the house with water to wash hands was the only handwashing indicator significantly associated with a child in the household who reported cough or difficulty breathing in the preceding 7 days (adjusted odds ratio 0.95, 95% confidence interval 0.93-0.98, P < 0.001).

CONCLUSION:
Handwashing indicators were strongly influenced by socio-economic status and so would not be an independent measure of handwashing behaviour. Handwashing promotion efforts in urban Dhaka that include specific efforts to provide handwashing facilities inside the house are more likely to improve handwashing behaviour than interventions that ignore this component.

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Author information

Author/s: Luby, Stephen P (SP); Halder, Amal K (AK);

Affiliation: International Centre of Diarrheal Disease Research, Dhaka, Bangladesh. sluby(-atsign-)icddrb.org

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.

Journal: Tropical medicine & international health : TM & IH (Trop Med Int Health), published in England. (Language: eng)

Reference: 2008-Jun; vol 13 (issue 6) : pp 835-44

Dates: Created 2008/05/16; Completed 2008/06/20;

PMID: 18363587, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Bangladesh - epidemiology
Child, Preschool
Cross-Sectional Studies
Female
Handwashing - standards
Health Behavior
Housing - standards
Humans

Infant
Infant, Newborn
Male
Respiration Disorders - epidemiology; etiology
Soaps - supply & distribution
Social Class
Socioeconomic Factors
Urban Health - statistics & numerical data

Associated Chemicals: Soaps (0)

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