Waterless hand sanitizer for diarrhea prevention in a humanitarian emergency

用于在人道主义紧急情况下预防腹泻的无水洗手液

• 批准号: 8462085
• 负责人: Pavani Kalluri Ram
• 金额: $ 40.97万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2014-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8462085
• 关键词: Waterless; hand; sanitizer; diarrhea; prevention

DESCRIPTION (provided by applicant): Diarrhea and acute respiratory infections account for nearly 30% of deaths among children displaced due to humanitarian emergencies, with diarrhea causing up to 40% of child deaths in acute emergency settings. Intense crowding and acute and chronic malnutrition contribute to the high burden of diarrhea and acute respiratory infection. Sanitation infrastructure can be overwhelmed quickly with the influx of displaced persons and water quality can be poor, contributing to the high diarrhea risk. Repeatedly, handwashing has been shown to be infrequent at times relevant to pathogen transmission. But, there is a wealth of evidence supporting the impact of handwashing promotion for prevention of both diarrhea and acute respiratory infections. Provision of soap to a refugee population has been shown to lead to maintenance of soap in the home, and fewer episodes of diarrhea in households with soap in the home. Water scarcity represents a critical barrier to handwashing with soap and water, particularly in the displaced persons' camp setting. Maintaining water for handwashing in small containers is a constant challenge, particularly when handwashing facilities are shared amongst unrelated households. The hectic nature of life in a displaced persons' settlement may further challenge adherence to handwashing with water and soap at various critical times. Waterless hand sanitizer has been adopted widely in high-income settings because of its efficiency, convenience, and elimination of the need for water. Many waterless sanitizers contain alcohol but alternative options, such as chlorhexidine gel, have similar antimicrobial efficacy and may be more acceptable to some populations with religious or cultural proscriptions against alcohol. In the humanitarian emergency context, a waterless method of improving hand hygiene could overcome water supply concerns, require less frequent replenishment than water, and represent an efficient method of hand cleansing at critical times. Moreover, waterless hand sanitizer can be efficiently distributed as part of hygiene kits. In the context of an ongoing humanitarian emergency, we propose to evaluate the acceptability of two formulations of waterless hand sanitizers, and to measure the impact of provision and promotion of waterless hand sanitizer on hand cleansing behavior and effectiveness for prevention of diarrhea morbidity and mortality. We will use qualitative research methods to investigate the acceptability and barriers to use of alcohol-based and non-alcohol based waterless hand sanitizers. We will distribute the most acceptable formulation in a displaced persons' settlement and evaluate uptake and impact of sanitizer uptake on diarrhea morbidity. Using a case-control study approach, we will evaluate the association between sanitizer uptake and diarrhea mortality. This innovative study will inform public health approaches to prevent unconscionably high rates of diarrhea mortality among young children affected by humanitarian emergencies. PUBLIC HEALTH RELEVANCE: During humanitarian emergencies, young children are particularly vulnerable to diarrhea episodes and death. We propose to understand whether use of hand sanitizer in the refugee camp setting will result in a decrease in diarrhea-related cases and deaths. This innovative project will inform international efforts to prevent diarrhea mortality among young children in humanitarian emergencies.

描述（由申请人提供）：在因人道主义紧急情况而流离失所的儿童死亡中，腹泻和急性呼吸道感染占近 30%，而在紧急情况下，腹泻导致儿童死亡的比例高达 40%。严重拥挤以及急慢性营养不良导致腹泻和急性呼吸道感染负担沉重。随着流离失所者的涌入，卫生基础设施可能很快就会不堪重负，而且水质可能很差，导致腹泻风险很高。事实一再证明，不经常洗手有时与病原体传播有关。但是，有大量证据支持促进洗手对预防腹泻和急性呼吸道感染的影响。事实证明，向难民提供肥皂可以促进家中肥皂的保存，并且家中拥有肥皂的家庭可以减少腹泻的发生。缺水是用肥皂和水洗手的一个严重障碍，特别是在流离失所者的营地中。在小容器中保存洗手用水是一项持续的挑战，特别是当不相关的家庭共用洗手设施时。流离失所者定居点生活的忙碌性质可能会进一步挑战在各个关键时刻坚持用水和肥皂洗手。无水洗手液因其高效、方便且不需要水而在高收入环境中被广泛采用。许多无水消毒剂含有酒精，但洗必太凝胶等替代选择具有类似的抗菌功效，并且可能更容易被一些宗教或文化禁止饮酒的人群所接受。在人道主义紧急情况下，改善手部卫生的无水方法可以克服供水问题，需要比水更少的补充频率，并且是在关键时刻清洁手部的有效方法。此外，无水洗手液可以作为卫生用品包的一部分进行有效分发。在持续的人道主义紧急情况下，我们建议评估两种无水洗手液配方的可接受性，并衡量提供和推广无水洗手液对手部清洁行为以及预防腹泻发病率和死亡率的有效性的影响。我们将采用定性研究方法来调查酒精类和非酒精类无水洗手液的可接受性和使用障碍。我们将在流离失所者的定居点分发最可接受的配方，并评估消毒剂的使用情况及其对腹泻发病率的影响。使用病例对照研究方法，我们将评估消毒剂的摄入与腹泻死亡率之间的关联。这项创新研究将为公共卫生方法提供信息，以防止受人道主义紧急情况影响的幼儿腹泻死亡率过高。 公共卫生相关性：在人道主义紧急情况下，幼儿特别容易发生腹泻和死亡。我们建议了解在难民营环境中使用洗手液是否会减少腹泻相关病例和死亡。这一创新项目将为预防腹泻死亡的国际努力提供信息 人道主义紧急情况下的幼儿。