Two new papers from the group

Bacterial hand contamination among Tanzanian mothers varies temporally
and following household activities
Amy J. Pickering, Timothy R. Julian, Simon Mamuya, Alexandria B.
Boehm, Jennifer Davis
Abstract
Objective: To characterize mechanisms of hand contamination with
faecal indicator bacteria and to assess the presence of selected
pathogens on mothers’ hands in Tanzania.
Methods: A household observational study combined with repeated
microbiological hand rinse sampling was conducted among 119 mothers in
Dar es Salaam, Tanzania. All hand rinse samples were analysed for
enterococci and Escherichia coli, and selected samples were analysed
for genetic markers of Bacteroidales, enterovirus and pathogenic E.
coli.
Results: Using the toilet, cleaning up a child’s faeces, sweeping,
cleaning dishes, preparing food and bathing were all found to increase
faecal indicator bacterial levels on hands. Geometric mean increases
in colony forming units per two hands ranged from 50 (cleaning dishes)
to 6310 (food preparation). Multivariate modelling of hand faecal
indicator bacteria as a function of activities recently performed
shows that food handling, exiting the household premises and longer
time since last handwashing with soap are positively associated with
bacterial levels on hands, while bathing is negatively associated.
Genetic markers of Bacteroidales, enterovirus and pathogenic E. coli
were each detected on a subset of mothers’ hands.
Conclusions: Escherichia coli and enterococci on hands can be
significantly increased by various household activities, including
those involving the use of soap and water. Thus, faecal indicator
bacteria should be considered highly variable when used as indicators
of handwashing behaviour. This work corroborates hands as important
vectors of disease among Tanzanian mothers and highlights the
difficulty of good personal hygiene in an environment characterized by
the lack of networked sanitation and water supply services.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2010.02677.x/full

The Effects of Informational Interventions on Household Water
Management, Hygiene Behaviors, Stored Drinking Water Quality, and Hand
Contamination in Peri-Urban Tanzania
By Jennifer Davis, Amy J. Pickering, Kirsten Rogers, Simon Mamuya, and
Alexandria B. Boehm
Abstract: Safe water storage and hand hygiene have been shown to
reduce fecal contamination and improve health in experimental
settings; however, triggering and sustaining such behaviors is
challenging. This study investigates the extent to which personalized
information about Escherichia coli contamination of stored water and
hands influenced knowledge, reported behaviors, and subsequent
contamination levels among 334 households with less than 5-year-old
children in peri-urban Dar es Salaam, Tanzania. One-quarter of the
study participants received information about strategies to reduce
risk of water- and sanitation-related illness. Respondents in another
three study cohorts received this same information, along with their
household's water and/or hand-rinse test results. Findings from this
study suggest that additional work is needed to elucidate the
conditions under which such testing represents a cost-effective
strategy to motivate improved household water management and hand
hygiene.
http://www.ajtmh.org/cgi/content/abstract/84/2/184