Related Experiment Video
Updated: Sep 19, 2025
A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Baseline Characteristics of a Cluster Randomized Controlled Trial Targeting Hand Hygiene in Primary Healthcare in
Anaïs Galli1,2, Mirko S Winkler1,2, Jan Hattendorf1,2
1University of Basel, Basel, Switzerland.
Objectives:
This study presents baseline characteristics of a cluster randomized controlled trial (cRCT) on hand hygiene in primary healthcare in Burkina Faso and Mali, addressing data gaps on hand hygiene practices in these settings.
Methods:
We implemented a two-arm cRCT in 48 primary healthcare facilities. Baseline data were collected (January-June 2023), followed by covariate-constrained randomization. We conducted covert hand hygiene observations, hand-rinse sampling for Escherichia coli detection, and a survey on behavioral factors among healthcare workers. The primary outcome is observed handwashing rate.
Results:
Baseline data included 309 healthcare workers. Trial arms were balanced in hand hygiene adherence, behavioral factors, and E. coli contamination. Hand hygiene adherence was low (12%). E. coli contamination was very high in Burkina Faso (76%) and considerable in Mali (23%). Participants had a high intention to wash their hands (93%) but only a quarter could name all moments for hand hygiene.
Conclusion:
Poor hand hygiene and E. coli contamination in our setting may heighten nosocomial infection risks. Interventions should address knowledge and build on high intentions to perform hand hygiene.
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