During the recent emergence of COVID-19, an increased practice of hand hygiene coincided with the reduced incidence of the norovirus epidemic in Japan, which is similar to experience with the pandemic flu in 2009. We investigated the relationship between the sales of hand hygiene products, including liquid hand soap and alcohol-based hand sanitizer, and the trend of norovirus epidemic. We used national gastroenteritis surveillance data across Japan in 2020 and 2021 and compared the base statistics of incidence of these two years with the average of the previous 10 years (2010-2019). We calculated the correlations (Spearman's Rho) between monthly sales of hand hygiene products and monthly norovirus cases and fitted them to a regression model. In 2020, there was no epidemic, and the incidence peak was the lowest in recent norovirus epidemics. In 2021, the incidence peak was delayed for five weeks to the usual epidemic seasons. Correlation coefficients between monthly sales of liquid hand soap and skin antiseptics and norovirus incidence showed a significantly negative correlation (Spearman's Rho = -0.88 and p = 0.002 for liquid hand soap; Spearman's Rho = -0.81 and p = 0.007 for skin antiseptics). Exponential regression models were fitted between the sales of each hand hygiene product and norovirus cases, respectively. The results suggest hand hygiene using these products is a potentially useful prevention method against norovirus epidemics. Effective ways of hand hygiene for increasing the prevention of norovirus should therefore be studied.
Humans ; Japan/epidemiology* ; COVID-19 ; Hand Hygiene ; Soaps ; Anti-Infective Agents, Local ; Norovirus

PURPOSE: This study aimed to assess hand hygiene (HH) compliance among visitors at a long-term care hospital in South Korea. METHODS: The study was conducted at a 502-bed long-term care hospital located in Gyeonggi-do Province. From July 1 to August 15, 2017, including more than 6 weekends and one holiday, a trained observer covertly assessed visitors' HH at all five units (360 beds in total) of the study hospital building until the completion of 1,000 HH opportunities (i.e., 200 opportunities per unit). The modified World Health Organization (WHO) HH observation form was used. Instead of professional categories and the “before clean/aseptic procedure” moment, the estimated age range for each visitor were recorded in four categories: children (<14 years old), adolescents (14~18), adults (19~64), and the elderly (≥65). The collected data were analyzed using SPSS 22.0. RESULTS: A total of 1,000 HH opportunities were observed from 766 visitors (an average of 1.31 per visitor) and the overall HH compliance rate was 20.3%. Overall, 53.7% of the HH cases were performed with soap and water. Among the 4 HH moments, the “after body fluid exposure risk” moment showed the highest compliance rate (83.5%); 93.9% used soap and water. The most commonly exposed potential body fluid among visitors was saliva (48.1%). CONCLUSION: For hospital visitors in long-term care hospitals, HH education programs including HH moments need to be developed and implemented. Further studies are necessary to evaluate visitors' HH compliance in various hospital settings and find the related variables influencing visitors' HH.
Adolescent ; Adult ; Aged ; Body Fluids ; Child ; Compliance ; Education ; Gyeonggi-do ; Hand Hygiene ; Hand ; Holidays ; Humans ; Korea ; Long-Term Care ; Observational Study ; Saliva ; Soaps ; Visitors to Patients ; Water ; World Health Organization

OBJECTIVES: The cholera outbreak in Yemen has become the largest in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. This study aimed to identify risk factors for cholera in this outbreak. METHODS: A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. In total, 59 cholera cases and 118 community controls were studied. RESULTS: The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had visitors from outside Aden Province; eating outside the house; not washing fruit, vegetables, and khat (a local herbal stimulant) before consumption; using common-source water; and not using chlorine or soap in the household. In the multivariate analysis, not washing khat and the use of common-source water remained significant risk factors for being a cholera case. CONCLUSIONS: Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.
Case-Control Studies ; Catha ; Chlorine ; Cholera ; Drinking Water ; Eating ; Family Characteristics ; Fruit ; Hygiene ; Multivariate Analysis ; Risk Factors ; Soaps ; Vegetables ; Water ; Yemen

OBJECTIVES: The cholera outbreak in Yemen has become the largest in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. This study aimed to identify risk factors for cholera in this outbreak.METHODS: A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. In total, 59 cholera cases and 118 community controls were studied.RESULTS: The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had visitors from outside Aden Province; eating outside the house; not washing fruit, vegetables, and khat (a local herbal stimulant) before consumption; using common-source water; and not using chlorine or soap in the household. In the multivariate analysis, not washing khat and the use of common-source water remained significant risk factors for being a cholera case.CONCLUSIONS: Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.
Case-Control Studies ; Catha ; Chlorine ; Cholera ; Drinking Water ; Eating ; Family Characteristics ; Fruit ; Hygiene ; Multivariate Analysis ; Risk Factors ; Soaps ; Vegetables ; Water ; Yemen

PURPOSE: The purpose of this study is to identify factors related to compliance with respiratory infection preventive behaviors including hand washing, cough etiquette, and oral hygiene of older adults. METHODS: A cross-sectional study was conducted with a convenience sample of 100 older adults (mean age: 76.11±6.35 years, female: 86.0%). Data were collected from a community senior center through face to face interviews by using instruments including measuring knowledge, perceived threat, self-efficacy, compliance with respiratory infection preventive behaviors. RESULTS: The mean score of knowledge was 7.52 out of 13 in total. The compliance with hand washing with soap was 6.0% for 8 or more times per day. Among the participants, 12.0% adhered to the cough etiquette. Sixty-two older adults (62.0%) didn't use interdental brushes or floss at all. The stepwise linear regression indicated that age and self-efficacy for respiratory infection preventive behaviors were significant factors and explained 24.0% of the compliance with hand washing and the cough etiquette. Education level, cancer diagnosis, and self-efficacy for respiratory infection preventive behaviors were significant predictors of oral hygiene. The factor with the greatest effect was self-efficacy in the two models. CONCLUSION: The findings suggest that it is necessary to improve compliance with respiratory infection preventive behaviors among older adults using senior centers. In order to enhance the compliance, it is necessary to develop nursing programs based on the self-efficacy for respiratory infection preventive behaviors in the senior centers.
Adult ; Compliance ; Cough ; Cross-Sectional Studies ; Diagnosis ; Education ; Female ; Hand Disinfection ; Hand Hygiene ; Humans ; Linear Models ; Nursing ; Oral Hygiene ; Respiratory Tract Infections ; Senior Centers ; Soaps

BACKGROUND: Intestinal parasitic infections are major public health problems worldwide, with high prevalence in low income countries where substandard food hygiene practices are common. Asymptomatic food handlers with poor personal hygiene could be potential sources of parasitic infections. This study was aimed to assess the prevalence of intestinal parasitic infections and associated factors among asymptomatic food handlers working at Haramaya University cafeterias, eastern Ethiopia. METHODS: A cross-sectional study was conducted among asymptomatic food handlers working at Haramaya University cafeterias from August 2015 to January 2016. Population proportion to size allocation and systematic random sampling techniques were used to identify the study participants. Stool samples were collected and examined simultaneouly using direct and modified formol ether concentration wet smear techniques. Data were entered and analyzed using SPSS version 20.0 software. Logistic regressions were applied to assess association between independent variable and intestinal parasitic infections. Statistical significance was declared at a p-value less than 0.05. RESULTS: A total of 417 asymptomatic food handlers were enrolled in this study. Of these, females comprised 79.4%. Large proportion (39.3%) of food handlers were in the age group of 31–40 years. The overall prevalence of intestinal parasitic infections was 25.2% (95% CI: 18.3, 29.6). Entamoeba histolytica/ dispar (46.7%) and A. lumbricoides (14.3%) were the most frequent isolates. Having no formal education [AOR: 2.13, 95% CI: 1.24, 3.67], monthly income of less than 45.7 USD [AOR: 3.86, 95% CI: 1.62, 9.20], lack of hand washing after the use of the toilet with soap [AOR: 2.43, 95% CI: 1.22, 4.86] and untrimmed fingernails [AOR: 3.31, 95% CI: 1.99, 5.49] have significant association with intestinal parasitic infections. CONCLUSIONS: The high prevalence of intestinal parasitic infections in this study highlights the importance of food handlers as probable sources of parasitic infections. Public health measures and sanitation programs should be strengthened to control the spread of intestinal parasitic infections.
Cross-Sectional Studies ; Education ; Entamoeba ; Ether ; Ethiopia ; Female ; Formaldehyde ; Hand Disinfection ; Helminths ; Humans ; Hygiene ; Logistic Models ; Nails ; Prevalence ; Public Health ; Sanitation ; Soaps

BACKGROUND: Diarrheal and intestinal infectious disease caused by inadequate drinking water, sanitation, and hygiene (WASH) is not only a great concern in developing countries but also a problem in low-income populations and rural areas in developed countries. In this study, we assessed the exposure to inadequate WASH in Korea and estimated the burden of disease attributable to inadequate WASH. METHODS: We used observational data on water supply, drinking water, sewage treatment rate, and hand washing to assess inadequate WASH conditions in Korea, and estimated the level of exposure in the entire population. The disease burden was estimated by applying the cause of death data from death registry and the morbidity data from the national health insurance to the population attributable fraction (PAF) for the disease caused by inappropriate WASH. RESULTS: In 2013, 1.4% of the population were exposed to inadequate drinking water, and 1.0% were living in areas where sewerage was not connected. The frequency of handwashing with soap after contact with excreta was 23.5%. The PAF due to inadequate WASH as a cluster of risk factors was 0.353 (95% confidence interval [CI], 0.275–0.417), among which over 90% were attributable to hand hygiene factors that were significantly worse than those in American and European high-income countries. CONCLUSION: The level of hand hygiene in Korea has yet to be improved to the extent that it shows a significant difference compared to other high-income countries. Therefore, improving the current situation in Korea requires a continuous hand washing campaign and a program aimed at all people. In addition, continuous policy intervention for improvement of sewage treatment facilities in rural areas is required, and water quality control monitoring should be continuously carried out.
Cause of Death ; Communicable Diseases ; Developed Countries ; Developing Countries ; Drinking Water* ; Drinking* ; Hand Disinfection ; Hand Hygiene ; Hygiene* ; Korea* ; National Health Programs ; Poverty ; Risk Factors ; Sanitation* ; Sewage ; Soaps ; Water Quality ; Water Supply

Terra firma-forme dermatosis (TFFD) is a bizarre, acquired and idiopathic dermatosis that etiology has still not been fully defined. It is characterized by the presence of asymptomatic, brownish dirt-like lesion maybe due to disorder of keratinization. These lesions cannot be removed with ordinary cleansing. Therefore, TFFD can be differentiated from dermatosis neglecta. Patient was a 17-year-old man with brownish lesions on his face for 1 month. The patient had a history of regular washing habit with soap and water. The lesions were asymptomatic however due to cosmetic reasons, the patient wanted to treat his skin lesions. Punch biopsy revealed hyperkeratosis and fungal spore are in stratum corneum. Salicylic acid peeling with alcohol base was performed on the patient's face. The skin lesions disappeared completely on gentle swabbing with peeling. In this point, the diagnosis of TFFD could be considered. Since, this disease can be confused with dermatosis neglecta, we report this case with literature review.
Adolescent ; Biopsy ; Diagnosis ; Humans ; Salicylic Acid* ; Skin ; Skin Diseases* ; Soaps ; Spores, Fungal ; Water

Terra firma-forme dermatosis (TFFD) is a bizarre, acquired and idiopathic dermatosis that etiology has still not been fully defined. It is characterized by the presence of asymptomatic, brownish dirt-like lesion maybe due to disorder of keratinization. These lesions cannot be removed with ordinary cleansing. Therefore, TFFD can be differentiated from dermatosis neglecta. Patient was a 17-year-old man with brownish lesions on his face for 1 month. The patient had a history of regular washing habit with soap and water. The lesions were asymptomatic however due to cosmetic reasons, the patient wanted to treat his skin lesions. Punch biopsy revealed hyperkeratosis and fungal spore are in stratum corneum. Salicylic acid peeling with alcohol base was performed on the patient's face. The skin lesions disappeared completely on gentle swabbing with peeling. In this point, the diagnosis of TFFD could be considered. Since, this disease can be confused with dermatosis neglecta, we report this case with literature review.
Adolescent ; Biopsy ; Diagnosis ; Humans ; Salicylic Acid* ; Skin ; Skin Diseases* ; Soaps ; Spores, Fungal ; Water

The aim of this study was to explore the association between daily toothbrushing frequency and health risk behaviors of school-going adolescents in poor urban areas of Peru. A cross-sectional survey was conducted among 959 school-going adolescents 11∼19 years of age in poor urban areas of Peru in 2014. Health risk behaviors we assessed in the study were smoking; drinking; consuming sugar-sweetened soft drinks (more than one cup); leisure time activities including watching television, playing games, and using the Internet; and never or rarely handwashing with soap. Daily toothbrushing frequency was divided into two groups (once and twice daily). For statistical analyses, the chi-square test and hierarchical logistic regression were used at 5% level of significance. Of the total respondents, 63 (14.3%) were boys and 53 (10.3%) were girls and 116 (12.1%) engaged in toothbrushing (≤once a day). According to the adjusted logistic regression analysis for socio-demographic characteristics, two behaviors (leisure time use activities, including watching television, playing games, and using the Internet (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.20∼4.35), and never or rarely hand washing with soap (OR, 4.09; CI, 2.48∼6.75) were statistically associated with toothbrushing frequency (≤once a day). We found two health risk behaviors (leisure time activities, including watching television, playing games, and using the Internet, and never or rarely handwashing with soap) associated with toothbrushing frequency among adolescents in the study area. Thus, oral health promotion programs should consider these health risk behaviors associated with toothbrushing frequency.
Adolescent* ; Carbonated Beverages ; Cross-Sectional Studies ; Drinking ; Female ; Hand Disinfection ; Humans ; Internet ; Leisure Activities ; Logistic Models ; Oral Health ; Peru* ; Risk-Taking* ; Smoke ; Smoking ; Soaps ; Surveys and Questionnaires ; Television ; Toothbrushing*