Evaluating effect of handwashing intervention among primary students of counties in Fujian province

Objective Diarrheal and respiratory diseases cause millions of deaths among children in the developing world each year.Studies demonstrated reduced rates of these diseases during intensive,ho me-based handw ashing interventions.To evaluate the effect of a schoo-l based handw ashinng progr am among 1st gr ade students to determine whether a more scalable,lowe-rcost interv ention could also affectillness rates.Methods Thirty schools from each of 3 counties in Fujian province,were randomized to one of the following groups:control;standard intervention,which included a handwashing program(1 hour of hygiene instruction and l soapsample kit perpupil);expanded intervention,which included the handwashing program and a supply of soapfor the school sinks.Teachers collected illness symptom information from students weekly and student absences daily between January and A pril,2005.Mean illness and absence rates were calculated for each school and were compar ed across groups.Wilcoxon ranksums were perfo rmed and p values <0.05 significant was considered.Results There were a total of 52 342 studen-tweeks of observation.In control schools,children experienced a median 2.04 episodes of absence(median 2.58 days of absence)per 100 studen-tweeks.In standard intervention schools,there were a median 1.15 episodes of absence(median 1.86 days of absence)per 100 studen-tweeks.Children in ex panded intervent ion schools experienced a median 1.19 episodes of absence(median 11.9 days of absence)per 100 student-weeks.T he control and ex panded intervention g roups differed sig nificantly in occurr ence of illness absence(P=0.03)and in number of days absent(P=0.02).Conclusion Provision of hand washing promotion program and soap was signig nicantly associated with reduction in illness,absence and days of absence among 1 st grade students in Fujian province.This low-cost,lar ge-scale intervention could improve the health of children world wide.