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Updated: Jul 14, 2026
A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Field trial of a low cost method to evaluate hand cleanliness
Stephen P Luby1, Mubina Agboatwalla, Ward Billhimer
1Division of Bacterial and Mycotic Diseases, National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. sluby@icddrb.org
A simple finger-print test using MacConkey agar to detect thermotolerant coliforms did not effectively assess handwashing practices in Karachi. Better methods are needed to measure hand hygiene behavior accurately.
Area of Science:
- Public Health
- Microbiology
- Epidemiology
Background:
- Assessing handwashing practices is crucial for preventing infectious diseases.
- Simple, low-cost methods are needed for objective evaluation of hand hygiene.
Purpose of the Study:
- To evaluate a direct finger imprint method using MacConkey agar for measuring hand contamination.
- To assess the utility of this method in evaluating handwashing practices in a community setting.
Main Methods:
- A subset of mothers from a handwashing promotion trial in Karachi, Pakistan, provided finger imprints on MacConkey agar.
- Plates were incubated to detect thermotolerant coliform bacteria, indicating fecal contamination.
Main Results:
- No significant difference in thermotolerant coliform detection was found between intervention and control groups.
- Hand contamination detected by this method did not correlate with reported household diarrhea rates.
Conclusions:
- The three-finger direct imprint test on MacConkey agar is not a reliable indicator of regular handwashing with soap.
- Development of improved methods for assessing handwashing behavior is a critical research need.
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