Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study Free

Abstract

Patients with AIDS frequently develop diarrhoeal illness. In this randomized, controlled study, 260 patients were screened for those who had not had diarrhoea in the preceding 3 months and who had received a stable highly active antiretroviral therapy regimen for at least 6 weeks prior to the study enrolment. A total of 148 patients met the inclusion criteria and were enrolled: 75 patients were randomly assigned to an intensive handwashing intervention (i.e. handwashing after defecation, after cleaning infants who had defecated, before preparing food, before eating, and before and after sex) and 73 patients were randomly assigned to the control group. Patients in both groups were called weekly by telephone to determine compliance with handwashing and to determine the number of diarrhoeal episodes for the preceding week. Patients were observed for 1 year. Patients assigned to the intensive handwashing intervention group washed their hands more frequently compared with the control group (seven vs four times a day, respectively; <0.05) and developed fewer episodes of diarrhoeal illness (1.24±0.9 vs 2.92±0.6 new episodes of diarrhoea, respectively; <0.001) during the 1 year observation. The most common pathogens identified in both groups in patients who developed diarrhoeal illness were , , and . These data suggest that intensive handwashing reduces diarrhoeal illness in patients with AIDS.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.46867-0
2007-05-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/56/5/659.html?itemId=/content/journal/jmm/10.1099/jmm.0.46867-0&mimeType=html&fmt=ahah

References

  1. Bellosillo N. A., Gorbach S. L. 1998; Diarrhea and HIV infection. Infect Dis Clin Pract 7:213–219 [CrossRef]
    [Google Scholar]
  2. Curtis V., Cairncross S. 2003; Effect of washing hands with soap on diarrhea risk in the community: a systematic review. Lancet Infect Dis 3:275–281 [CrossRef]
    [Google Scholar]
  3. Haggerty P. A., Muladi K., Kirkwood B. R., Ashworth A., Manunebo M. 1994; Community-based hygiene education to reduce diarrhoeal disease in rural Zaire: impact of the intervention on diarrhoeal morbidity. Int J Epidemiol 23:1050–1059 [CrossRef]
    [Google Scholar]
  4. Huang D. B., DuPont H. L., Jiang Z. D., Carlin L., Okhuysen P. C. 2004; Interleukin-8 response in an intestinal HCT-8 cell line infected with enteroaggregative and enterotoxigenic Escherichia coli . Clin Diagn Lab Immunol 11:548–551
    [Google Scholar]
  5. Kartalija M., Sande M. A. 1999; Diarrhea and AIDS in the era of highly active antiretroviral therapy. Clin Infect Dis 28:701–707 [CrossRef]
    [Google Scholar]
  6. Kojima S., Kageyama T., Fukushi S., Hoshino F. B., Shinohara M., Uchida K., Natori K., Takeda N., Katayama K. 2002; Genogroup-specific PCR primers for detection of Norwalk-like viruses. J Virol Methods 100:107–114 [CrossRef]
    [Google Scholar]
  7. Luby S. P., Agboatwalla M., Painter J., Altaf A., Billhimer W. L., Hoekstra R. M. 2004; Effect of intensive handwashing promotion on childhood diarrhea in high-risk communities in Pakistan. JAMA 291:2547–2554 [CrossRef]
    [Google Scholar]
  8. National Committee for Clinical Laboratory Standards; 1999; Performance Standards for Antimicrobial Susceptibility Testing . Ninth International Supplement vol 19M100–S9 Villanova, PA: National Committee for Clinical Laboratory Standards;
    [Google Scholar]
  9. Shahid N. S., Greenough W. B. III, Samadi A. R., Huq M. I., Rahman N. 1996; Handwashing with soap reduces diarrhea and spread of bacterial pathogens in a Bangladesh village. J Diarrhoeal Dis Res 14:85–89
    [Google Scholar]
  10. Shimizu M., Ohta K., Wada H., Sumita R., Yachie A., Koizumi S. 2006; Cytomegalovirus-associated protracted diarrhea in an immunocompetent boy. J Paediatr Child Health 42:259–262 [CrossRef]
    [Google Scholar]
  11. Smith P. D., Quinn T. C., Strober W., Janoff E. N., Masur H. 1992; NIH conference. Gastrointestinal infections in AIDS. Ann Intern Med 116:63–77 [CrossRef]
    [Google Scholar]
  12. Stockmann M., Fromm M., Schmitz H., Schmidt W., Riecken E. O., Schulzke J. D. 1998; Duodenal biopsies of HIV-infected patients with diarrhoea exhibit epithelial barrier defects but no active secretion. AIDS 12:43–51 [CrossRef]
    [Google Scholar]
  13. Thomas P. D., Pollok R. C., Gazzard B. G. 1999; Enteric viral infections as a cause of diarrhoea in the acquired immunodeficiency syndrome. HIV Med 1:19–24 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.46867-0
Loading
/content/journal/jmm/10.1099/jmm.0.46867-0
Loading

Data & Media loading...

Most cited Most Cited RSS feed