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Evidence of behaviour change following a hygiene promotion programme in Burkina Faso.

OBJECTIVES: To determine whether a large, 3-year hygiene promotion programme in Bobo-Dioulasso, Burkina Faso, was effective in changing behaviours associated with the spread of diarrhoeal diseases. The programme was tailored to local customs, targeted specific types of behaviour, built on existing motivation for hygiene, and used locally appropriate channels of communication. METHODS: Two population surveys recorded the coverage of the programme among target audiences (mothers of children aged 0-35 months). Four surveys were carried out: three prior to the programme and one in 1998 (after the programme had been running for 3 years), using structured observation of hygiene behaviours in the participants' homes to document changes in target behaviours. FINDINGS: After the programme had run for 3 years, three-quarters of the mothers targeted had had contact with programme activities. Half could cite the two main messages of the programme correctly. Although the safe disposal of children's stools changed little between 1995 and 1998 (80% pre-intervention, 84% post-intervention), hand-washing with soap after cleaning a child's bottom rose from 13% to 31%. The proportion of mothers who washed their hands with soap after using the latrine increased from 1% to 17%. CONCLUSION: Hygiene promotion programmes can change behaviour and are more likely to be effective if they are built on local research and use locally appropriate channels of communication repeatedly and for an extended time.

Burkina Faso↗

Observation of wounding characteristics in dogs wounded by super velocity projectile.

OBJECTIVE: To understand wounding characteristics in dogs wounded by super velocity projectile with a purpose of providing a basis for prevention and treatment of such wounds. METHODS: A specially-made explosive gun was used to shoot aluminium bullet weighing 3.0 g and 1.4 g to injure both legs of dogs at velocities of 2330 m/s, 3200 m/s and 4250 m/s, respectively, and the soap specially made was also shot. At the same time, steel ball of 1.03 g was shot with a Type 53 smooth chamber gun at a speed of 1280 m/s. Within 30 min after wounding, debridement and pathological anatomy were performed and specimens were taken for light microscope observation. RESULTS: When the dogs were wounded by the 3 g bullet at speed of 2330 m/s, the entrance of the left leg was penetrated explosively with a defect area of 225 cm(2), and the femur trunk was also injured and the residual femur had comminution fracture. The exit of the right leg was blindly wounded with a defect area of 63 cm(2), but only the skin was not penetrated. Both testes and part pelvis were injured too. Under light microscope, degenerative myofibers and bleeding of the spatium between the myofibers could be found at the place 4 cm away from the wounding track. Furthermore, serious bleeding of the bladder and blood vessels of the brain could be observed. The lungs showed changes of blast injury. Vacuolar change was presented in the cytoplasm of hepatocytes. Injuries of the animals in other two experimental groups were similar to those described above, but the defect area of the wounded track was 124 cm(2) in the group of 4250 m/s. Injuries caused by the steel ball were milder than caused by the explosive gun. The volume of the residual cavity in the soap was 5000 ml. CONCLUSIONS: The super-velocity projectile causes destructive damage to the local tissues and multi-organ injuries. Therefore, the practical medical care needs not only amputation but also management of multi-organ injuries.

Animals↗

[Cosmetic treatments and acne].

Cosmetic products contribute to the efficacy of anti-acneic treatment. Cleaning bars without soap and lotions are to be preferred to soaps. Morning application of moisturizing creams compensate for dryness and irritation induced by topical treatment. Some of these cosmetic products may have a limited efficacy of the shiny appearance and/or acne lesions. Scrubs, abrasive sponges, masks and patches have a very limited usefulness. Make up and camouflage techniques are authorized, provided that the products have been tested non comedogenic and non acne-genic.

Acne Vulgaris↗

The effect of different polishing techniques on the surface roughness of acrylic resin materials.

This study evaluated three methods of surface polishing on acrylic denture base materials. Specimens of three commercial heat-cured acrylic resin materials were finished using burs, sandpaper discs and rubber wheels, and polished with polishing soap, paste, or by application of a UV-light-activated resin sealant. The resulting surface roughness was examined by scanning electron microscopy as well as measured by means of a stylus profile Perthometer. Surface roughness was reduced by polishing. Polishing paste and UV-light-activated resin sealant were more, and equally, effective in reducing surface roughness compared to polishing soap. Polishing paste or UV-light-activated resin sealant may be used to create a smoother surface on acrylic dentures.

Acrylic Resins↗

Organophosphate poisoning.

Stay safe! Certain scenes and scenarios invite a greater degree of caution. Wear protective gear (Level B for decon) and make sure the patient is hazmat-naked prior to decontamination. Use tincture of green soap or household dishwashing soap to decontaminate your patient. Maintain the patient's airway using oral/nasal airways; intubate if indicated. Give high-flow oxygen by nonrebreather oxygen mask or, if intubated, with a bagh-valve mask. Treat for shock by maintaining the patient's body temperature, keeping them supine if they will tolerate it, and gaining i.v. access. Administer oxygen, atropine, pralidoxime chloride and diazepam as required. Notify the ED and transport rapidly. If it is a terrorist incident, get your patient and get out.

Decontamination↗

Cutaneous cleansers.

Skin cleansers may be an important adjunct to the regimen of those who use cosmetics, have sensitive or compromised skin, or utilize topical therapies. Cleansers emulsify dirt, oil and microorganisms on the skin surface so that they can be easily removed. During cleansing, there is a complex interaction between the cleanser, the moisture skin barrier, and skin pH. Cleansing, with water soap or a liquid cleanser, will affect the moisture skin barrier. Soap will bring about the greatest changes to the barrier and increase skin pH. Liquid facial cleansers are gentler, effecting less disruption of the barrier, with minimal change to skin pH, and can provide people with a cleanser that is a combination of surfactant classes, moisturizers and acidic pH in order to minimize disruption to the skin barrier.

Detergents↗

Exposure of spray-men to dieldrin in residual spraying.

A study of the exposure of spray-men to dieldrin was made in a pilot scheme of residual spraying in the Taveta-Pare area of East Africa. A detailed work study was completed on the operators, and sources of contamination were enumerated. Filter paper pads were placed on the skin and outside clothing and the pick-up was estimated chemically. A spray-man, while using the daily average of 2.12 kg (4.7 pounds) of dieldrin and observing the protective measures laid down, received a dermal exposure of 1.8 mg of dieldrin per kg of body-weight per day. This was possibly reduced somewhat by washing with soap and water upon completion of each day's work. The sixteen spray-men and assistants were exposed for 180 days per year and there was an interim period of 2 months between spray cycles. No clinical symptoms of poisoning were observed.Comparison is made with certain programmes where dieldrin poisoning has occurred. Attention is drawn to the reduced time of exposure in the Taveta-Pare scheme, personal washing, the great value of protective clothing and of its daily washing in soap and water and the need to use a dilute suspension of wettable powder for spraying.

Africa, Eastern↗

Food hygiene practices of food vendors in secondary schools in Ilorin.

This descriptive study was carried out to determine food safety practices among food Vendors in secondary schools in Ilorin. Pre-tested questionnaire and observational checklist were administered to 185 respondents recruited using inclusion and exclusion criteria. One hundred and eighty-two (98.4%) of the subjects were females and only 6(3%) were teenagers. One hundred and two (56.8%) had no formal education while 72(39% had received training on food hygiene. Pre-employment medical examination practice was high 141(76%) but periodic medical examination was low 30(16%). Sixty-one (33%) and seventy-two(39%) respondents prepared food well in advance and reheat food before sale respectively. Vendors who prepared food well in advance (over 4 hours) were found to practise food re-heating more than those who prepared food within 4 hours before sale, and this is statistically significant. The major unhygienic practices observed among the food vendors were poor care of used utensils 100(54%), use of previously used water for washing and cleaning, lack of covering apron among the vendors 128(69%) and lack of wash hand basin for immediate cleaning 61(33%). Only 85(46%) of the respondents used soap and water to clean their utensils while the rest 100(54%) used unhygienic methods to clean their utensils. It was observed that respondents who used soap and water for cleaning, vended food at locations that were relatively closer to water source, compared to other vendors who used other methods to clean their utensils. This is also statistically significant. Unkempt fingernails, skin lesions and poor food protection from flies were some of the food contaminating risk factors observed in the study. The need exists for food vendors and other food handlers to be trained on basic principles of safe food handling.

Adolescent↗

Sero-epidemiological study of hepatitis A virus infection among hill-tribe youth and household environmental sanitation, a hill-tribe community in northern Thailand.

A cross-sectional analytic study of 190 hill-tribe youth in a community in the north of Thailand was conducted to investigate the sero-prevalence of HAV and factors related to positive anti-HAV antibody. The studied youth, whose ages ranged from 15 to 24 years, were interviewed about socio-economic status and personal hygiene. Blood specimens were collected to detect anti-HAV by ELISA commercial kit. Household environmental sanitation conditions were observed and drinking water samples were screened for bacterial contamination using SI2 medium. Following the anti-HAV assay, the studied youth were divided into two groups: anti-HAV positive, and anti-HAV negative. The studied variables of the two groups were analyzed by chi2 test to find factors related to anti-HAV positivity. The results revealed that 87% of the studied youth were positive for anti-HAV. There was no statistically significant difference between age group/gender and anti-HAV positivity, p = 0.46 and 0.16, respectively. Approximately 35.79 to 45.79% washed their hands with soap before preparing food, before eating and after using the latrine. About 88% did not improve the potability of their drinking water. The results of screening for bacterial contamination in drinking water samples found that 73.53% were contaminated with coliform bacteria. Factors related to positive anti-HAV antibody included monthly income, number of household members, use of latrine, hand-washing with soap after using latrine, household refuse management and control of insects and rodents; p = 0.04, 0.007, 0.013, 0.008, <0.001 and <0.001, respectively. The findings suggested that appropriate household environmental management should be improved in this community to reduce HAV transmission.

Adolescent↗

Update on travelers' health.

As an international traveler, contact your health care provider at least 4 to 6 weeks before departure to obtain needed vaccinations and prophylactic medications. Be aware of the occurrence of any disease outbreaks in the countries you are visiting. While traveling, don't forget that one of the most important practices in preventing illness from infections is handwashing. Wash your hands carefully and frequently with soap and water, and if soap and water are not available use an alcohol-based hand rub. Be a responsible traveler by becoming informed about health risks and what to do to avoid them before you travel.

Centers for Disease Control and Prevention, U.S.↗

[Hand hygiene: first measure to control nosocomial infection].

Hand hygiene prevents cross infection in hospi tals, however adherence to guidelines is commonly poor. The hand-hygiene promotion programme started on May 2004 at the University Hospital of Liège after a baseline survey of compliance. We attempted to promote hand hygiene and most par ticularly alcohol-based hand disinfection. We measured MRSA transmission rates and consumption of alcohol-based handrub solution and soap in parallel. During the campaign, consump tion of alcohol-based handrub solution and soap increased by 56% and 24% respectively and MRSA transmission rates decreased from 11,04 to 7,07 cases per 1000 admissions.

Belgium↗

Benefits of mild cleansing: synthetic surfactant based (syndet) bars for patients with atopic dermatitis.

Atopic dermatitis (AD) is a recurring inflammatory skin disease, characterized by marked pruritus, which usually develops in early childhood. AD is associated with a wide array of symptoms, including itching, dryness, erythema, crusted lesions, and superficial inflammation. Topical steroid cream or ointment with proper washing is a primary treatment approach for AD. Nonsoap-based personal washing or syndet bars containing synthetic detergents or surfactants are milder than soaps; thus, they are widely used by patients with a variety of skin conditions, including AD. The primary goals of this study were to determine the compatibility of syndet bar use with the therapy of AD and the potential benefits of syndet bars compared with subjects' usual cleansing products, mostly soap bars. In this evaluation, 50 subjects (14 subjects were aged < or =15 years) with mild AD on a stable treatment regimen were recruited and asked to use 1 of 2 syndet bars as part of their normal shower routine for 28 days. The severity of eczematous lesions, skin condition (dryness, erythema, texture), and hydration were evaluated at baseline and after 28 days of syndet application by investigators and subjects. Syndet bar use reduced the severity of eczematous lesions, improved skin condition, and maintained hydration. Overall, the results of this study indicate that syndet formulations are compatible with the therapy of AD.

Administration, Cutaneous↗

Cholera outbreak in southeast of iran: routes of transmission in the situation of good primary health care services and poor individual hygienic practices.

Within the years 2001 to 2004 Sistan-va-Baluchestan was the only province with transmission of cholera in Iran. The objective of this study was to determine the epidemiological characteristics of the cholera outbreak that occurred in 2004 in the Sarbaz district in the southern parts of this province. The surveillance data were analyzed, and a matched case-control study was performed. From 22 October to 15 November 2004, from 2,242 diarrhea cases that were sampled for stool culture, 90 cases were positive for Vibrio cholerae O1 El-Tor biotype, serotype Ogawa. Multivariate analysis showed that risk factors for cholera were drinking beverages from street vendors (OR = 10.16, 95% CI: 2.55 - 40.50), illiteracy (OR = 5.76, 95% CI: 2.63 - 30.09), no hand washing with soap after toilet use (OR = 22.06, 95% CI: 2.91 - 167.11), no hand washing with soap before meals (OR = 3.64, 95% CI: 1.03 - 12.82), sex (OR = 3.73, 95% CI: 1.17 - 11.89) and eating food left over from previous meals without reheating (OR = 4.03, 95% CI: 1.23 - 13.18). The source of drinking water showed weak association with cholera only in univariate analysis (OR = 2.83, 95% CI: 1.12 - 7.19). The development of primary health care, even though it can improve the conditions that control the spread of an epidemic, is not enough of a control measure as long as the social hygienic standards are low and people do not follow the basic personal hygiene regulations.

Adolescent↗

Outbreak of community-acquired methicillin-resistant Staphylococcus aureus skin infections among a collegiate football team.

CONTEXT: Methicillin-resistant Staphylococcus aureus (MRSA) was once primarily a hospital-acquired organism, but now community-acquired MRSA (CA-MRSA) is causing outbreaks among otherwise healthy sport participants. OBJECTIVE: To investigate MRSA skin and soft tissue outbreaks within a collegiate football team and the effect of infection control measures over 3 years. DESIGN: Retrospective analysis. SETTING: College. PATIENTS OR OTHER PARTICIPANTS: Collegiate football team. INTERVENTION(S): Infection control measures included education, following Centers for Disease Control and Prevention recommendations, nasal cultures, hexachlorophene 3% soap, disposable towels, and hand sanitizers. MAIN OUTCOME MEASURE(S): Number of MRSA infections and hospitalizations. RESULTS: Complicated skin and soft tissue infections (those requiring surgical debridement and/or hospitalization) were diagnosed in 2 (1.8%) of 107 players in 2002, 17 (15.8%) of 107 players in 2003, and 1 (0.96%) of 104 players in 2004. CONCLUSIONS: Outbreaks of CA-MRSA in sports teams are very serious, and recognition is crucial. Treatment includes incision for proper drainage, bacterial culture and sensitivity, and appropriate antibiotic therapy. Infection control measures include educating athletes and staff, following Centers for Disease Control and Prevention recommendations, identifying CA-MRSA carriers with nasal cultures, introducing hexachlorophene 3% soap intermittently in the showers, making alcohol-based hand sanitizers available on the field, disinfecting weight training and rehabilitation equipment, and using disposable towels on the field during practices and games.

Journal Article↗

Endodontic diagnosis: clinical aspects.

The objectives of this article are to review classic and current concepts on endodontic diagnosis, to describe the current classification of the pulp and periradicular diseases and to present and discuss the diagnostic tools available for endodontic diagnosis. The "SOAP" approach to endodontic diagnosis is a very efficient and simple method to accomplish accurate diagnosis. SOAP serves as a mnemonic to guide the clinician in data collection and stands for: Subjective, Objective, Assessment, and Plan.

Dental Pulp↗

Triclosan.

Triclosan is a common antibacterial chemical currently in widespread use in household and health care-related products. Triclosan was first introduced in 1965 and has been marketed as cloxifenol, Irgasan CH 3565, and Irgasan DP 300. Its most common use is in antimicrobial hand soaps, but in the United States it can also be found in consumer products such as liquid dishwashing soaps, deodorants, and toothpastes. The concentrations used in products in the United States typically range from 0.15 to 0.3%. While allergy to triclosan-based products is uncommon, several cases of contact dermatitis secondary to triclosan have been reported.

Anti-Infective Agents, Local↗

Percutaneous absorption of [14C]DDT and [14C]benzo[a]pyrene from soil.

The objective was to determine percutaneous absorption of DDT and benzo[a]pyrene in vitro and in vivo from soil into and through skin. Soil (Yolo County 65-California-57-8; 26% sand, 26% clay, 48% silt) was passed through 10-, 20-, and 48-mesh sieves. Soil then retained by 80-mesh was mixed with [14C]-labeled chemical at 10 ppm. Acetone solutions at 10 ppm were prepared for comparative analysis. Human cadaver skin was dermatomed to 500 microns and used in glass diffusion cells with human plasma as the receptor fluid (3 ml/hr flow rate) for a 24-hr skin application time. With acetone vehicle, DDT (18.1 +/- 13.4%) readily penetrated into human skin. Significantly less DDT (1.0 +/- 0.7%) penetrated into human skin from soil. DDT would not partition from human skin into human plasma in the receptor phase (less than 0.1%). With acetone vehicle, benzo[a]pyrene (23.7 +/- 9.7%) readily penetrated into human skin. Significantly less benzo[a]pyrene (1.4 +/- 0.9%) penetrated into human skin from soil. Benzo[a]pyrene would not partition from human skin into human plasma in the receptor phase (less than 0.1%). Substantivity (skin retention) was investigated by applying 14C-labeled chemical to human skin in vitro for only 25 min. After soap and water wash, 16.7 +/- 13.2% of DDT applied in acetone remained absorbed to skin. With soil only 0.25 +/- 0.11% of DDT remained absorbed to skin. After soap and water wash 5.1 +/- 2.1% of benzo[a]pyrene applied in acetone remained absorbed to skin. With soil only 0.14 +/- 0.13% of benzo[a]pyrene remained absorbed to skin.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗

Suspected link between exposure to hexachlorophene and malformed infants.

Retrospective studies, performed in 6 hospitals in Sweden, demonstrated that severe congenital malformations occurred more frequently in neonates born to mothers who used hexachlorophene soaps, 10--60 times a day by handwashing and hand-creams during at least the first trimester of pregnancy (25 severe malformations in 460 neonates), when compared to neonates born to similarly employed mothers who did not use hexachlorophene soaps (0 severe malformations in 233 neonates). Minor congenital anomalies were also more commonly noted in the hexachlorophene-exposed group when contrasted with controls. Other known adverse influences, such as age, infections during pregnancy, other drug usage, or smoking habits did not appear different in the two groups.

Abnormalities, Drug-Induced↗