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      Identifying behavioural determinants for interventions to increase handwashing practices among primary school children in rural Burundi and urban Zimbabwe

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          Abstract

          Background

          This article presents the development of a school handwashing programme in two different sub-Saharan countries that applies the RANAS (risk, attitudes, norms, ability, and self-regulation) systematic approach to behaviour change.

          Methods

          Interviews were conducted with 669 children enrolled in 20 primary schools in Burundi and 524 children in 20 primary schools in Zimbabwe. Regression analyses were used to assess the influence of the RANAS behavioural determinants on reported handwashing frequencies.

          Results

          The results revealed that, in both countries, a programme targeting social norms and self-efficacy would be most effective. In Burundi, raising the children’s perceived severity of the consequences of contracting diarrhoea, and in Zimbabwe, increasing the children’s health knowledge should be part of the programme.

          Conclusions

          The school handwashing programme should create awareness of the benefits of handwashing through educational activities, raise the children’s ability and confidence in washing hands at school through infrastructural improvements, and highlight the normality of washing hands at school through events and poster creation.

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          Most cited references43

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          Hygiene: new hopes, new horizons

          Summary Although promotion of safe hygiene is the single most cost-effective means of preventing infectious disease, investment in hygiene is low both in the health and in the water and sanitation sectors. Evidence shows the benefit of improved hygiene, especially for improved handwashing and safe stool disposal. A growing understanding of what drives hygiene behaviour and creative partnerships are providing fresh approaches to change behaviour. However, some important gaps in our knowledge exist. For example, almost no trials of the effectiveness of interventions to improve food hygiene in developing countries are available. We also need to figure out how best to make safe hygiene practices matters of daily routine that are sustained by social norms on a mass scale. Full and active involvement of the health sector in getting safe hygiene to all homes, schools, and institutions will bring major gains to public health.
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            Effects of Hand Hygiene Campaigns on Incidence of Laboratory-confirmed Influenza and Absenteeism in Schoolchildren, Cairo, Egypt

            To evaluate the effectiveness of an intensive hand hygiene campaign on reducing absenteeism caused by influenza-like illness (ILI), diarrhea, conjunctivitis, and laboratory-confirmed influenza, we conducted a randomized control trial in 60 elementary schools in Cairo, Egypt. Children in the intervention schools were required to wash hands twice each day, and health messages were provided through entertainment activities. Data were collected on student absenteeism and reasons for illness. School nurses collected nasal swabs from students with ILI, which were tested by using a qualitative diagnostic test for influenza A and B. Compared with results for the control group, in the intervention group, overall absences caused by ILI, diarrhea, conjunctivitis, and laboratory-confirmed influenza were reduced by 40%, 30%, 67%, and 50%, respectively (p<0.0001 for each illness). An intensive hand hygiene campaign was effective in reducing absenteeism caused by these illnesses.
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              Social contacts of school children and the transmission of respiratory-spread pathogens.

              Empirical data about contact frequencies of children is needed for estimating parameters in mathematical modelling studies that investigate the effect of targeting influenza intervention to children. A survey about the social contacts of school children was conducted in a primary school in Germany. The distribution of the daily numbers of contacts was stratified by age of the contacted person and by weekday. A negative binomial regression analysis was performed to investigate factors that influence contact behaviour. Using logistic regression analysis we examined the relationship between the numbers of private contacts and having been ill in the last 6 months. We computed effective contact numbers to take the heterogeneity in contact behaviour into account in assessing the contribution of children's contacts to the overall transmission of an infection. The possible effects of intervention measures such as school closure and vaccination on the transmission of respiratory-spread agents to other age groups are discussed.
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                Author and article information

                Contributors
                elisabeth.seimetz@eawag.ch
                jurgita.slekiene@eawag.ch
                max.friedrich@eawag.ch
                +41 (0)58 765 55 42 , hans-joachim.mosler@eawag.ch
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                14 July 2017
                14 July 2017
                2017
                : 10
                : 280
                Affiliations
                ISNI 0000 0001 1551 0562, GRID grid.418656.8, Department of Environmental Social Sciences, , Eawag: Swiss Federal Institute of Aquatic Science & Technology, ; Ueberlandstrasse 133, P.O. Box 61, 8600 Duebendorf, Switzerland
                Article
                2599
                10.1186/s13104-017-2599-4
                5513052
                28705260
                6c4c76f9-7fa6-4775-bf0e-b7e95db698a0
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 July 2016
                : 7 July 2017
                Funding
                Funded by: Swiss Agency for Development and Cooperation
                Award ID: 7F-08209.02
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Medicine
                handwashing with soap,diarrheal,behavioural determinants,campaign development,school children,sub-saharan africa

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