Hand Washing Hygiene Research Articles

Impact of hand hygiene knowledge on the hand hygiene compliance.

Aim Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non-professional sphere by lay population. Aim of this study was to map the hand hygiene knowledge and its compliance in the monitored group of people. Methods The research was conducted at the Jessenius Faculty of Medicine in Martin of Comenius University in Bratislava (JFM CU) among seventy 3rd year students of General Medicine (medical study program), and Nursing, Midwifery and Public Health (non-medical study programs). Knowledge of hygienic hand washing according to the WHO guidelines from 2009 was investigated, as well as differences in the level of microbial contamination of hands after routine hand washing between the group that had been acquainted with hand hygiene protocols and the group that had not sufficiently. Results The results have shown that 32.9% of the students did not perform hygienic hand washing properly. The differences between the groups of students with and without the proper hand hygiene compliance in routine hand washing were not statistically significant. Conclusion The results of our survey have suggested that the reasons for decreased compliance with hand washing protocols may be related to forgetting to wash the hands or not being acquainted with hand washing protocols at all. The strategies focused only on one aspect of hand hygiene are, according to scientific literature, ineffective in the long term.

Determinant factors associated with parasitic infestation among pediatric cases with unexplained eosinophilia

Background: In tropical countries like India, common causes of eosinophilia are parasitic infestation, unhygienic living condition, and poor sanitation that accounts for high worm infestation in India. Objective: The present study was aimed to study the association between various risk factors and parasitic infestation in pediatric cases with unexplained eosinophilia. Materials and Methods: The study population comprised of 384 children. A well predesigned and pre-tested questionnaire was used to collect detailed related history and sociodemographic details. Saline and iodine wet mount of stool sample was made to detect intestinal parasites. For detection of microfilaria, Leishman’s staining of peripheral blood smear was done. Finally, the statistical analysis of the collected data was carried out. Results: Out of 384 participants, 7.03% of the total population was found to be positive for intestinal parasites. None of the peripheral blood smears showed the presence of microfilaria. Most of the positive study participants were from low or middle socioeconomic sectors. Very few parents were graduates. 6.5% of children in this category were found to show parasites in their stool samples. Hygiene status, hand washing, and stool disposal habits of patients were found to be significantly associated with the presence of the parasite. Conclusion: Possible sociodemographic, environmental and behavioral factors associated with parasitic infestation among pediatric cases with unexplained eosinophilia need to be studied to implement effective control measures so as to provide better health care and health benefits to the children.

Evaluation of Lead Exposure by Hand Wipes: A Review of the Effectiveness of Personal Hygiene on Industrial Sites

To evaluate the effectiveness of personal hygiene (handwashing) amongst workers at industrial sites to remove lead from their hands, a retrospective analysis of hand wipe samples was conducted using data collected by two contractors from two bridge painting projects for total lead using method ASTM E-1979-17/EPA SW846 7000B. Exposures resulted from the removal of lead-based paint from the structure and trace elements of lead found in the abrasive blast media. In total, six work tasks were evaluated and sixty unique hand wipe samples were evaluated. Thirty samples were collected during the worker’s lunch break, after they had reportedly washed their hands with a further 30 collected at the end of the workday following the same protocol. To be included in this evaluation, the contractors were required to follow NIOSH Method 9105 (Lead in Dust Wipes-Dermal Surfaces) with subsequent analysis of samples for total lead by an American Industrial Hygiene Association (AIHA) accredited laboratory. All 60 samples contained detectable lead. The lead exposures ranged from 19.5 μg to 3420 μg. The geometric mean for the samples collected was 337 μg. These results indicate that current personal hygiene practices at the evaluated sites are not effective at removing lead from worker’s hands during and after the workday. They also suggest that the residual lead measured on the workers’ hands, at the end of the shift, is likely contributing to the elevated blood lead levels in this population.

A cross sectional study regarding awareness and importance of hygiene hand washing practices among health care professionals

A cross sectional study regarding awareness and importance of hygiene hand washing practices among health care professionals

The study of an effective intervention to reinforce a hygienic hand-washing

The study of an effective intervention to reinforce a hygienic hand-washing

Effectiveness of Hygienic Hand Washing Training on Hand Washing Practices and Knowledge: A Nonrandomized Quasi-Experimental Design.

Nurses undertake important responsibilities in patient care and the prevention of hospital-acquired infections. However, adherence to hand hygiene practices among nurses has been reported to be low. This study aims to evaluate the effectiveness of hygienic hand washing training on hand washing practices and knowledge. The study design was a nonrandomized, quasi-experimental study, with pretest-posttest for one group. Pre- and postobservations were also conducted using an observation form on any 5 workdays to evaluate the effectiveness of hygienic hand washing training on hand washing practices. The study was conducted with 63 nurses working at a hospital in Istanbul. Hand Hygiene Knowledge Form scores after hygienic hand washing training were higher than the pretraining scores. The number of the nurses' hand hygiene actions after hand hygiene training increased significantly compared with that before training. The results indicate that training in proper hand washing techniques and hygienic hand washing practices positively affects the knowledge level of nurses and their hand washing behavior. J Contin Educ Nurs. 2018;49(8):360-371.

The Effect of Therapeutic Clowning on Handwashing Technique and Microbial Colonization in Preschool Children

This study aimed to determine the effect of therapeutic clowning on handwashing technique and microbial colonization in preschool children. This randomized controlled trial was conducted using pre-test and post-test experimental and control groups. The study was conducted between March and June 2016 in two kindergartens in eastern Turkey. The study was completed with a total of 195 students, including 90 students in the experimental group and 105 students in the control group. A questionnaire was used for data collection. This questionnaire included sections about the subjects' descriptive characteristics and the results of the bacterial cultures of their hand swabs. For the collection of these swabs, the subjects were informed in advance, and samples were collected at predetermined times. The swabs were analyzed to determine the bacterial colonization of the subjects' hands. Clowns and video activities were used as intervention tools in the study. In the post-test, the microbial growth was ≤103 in 68.9% and >103 in 31.1% of the subjects in the experimental group. In contrast, the growth was ≤103 in 34.3% and >103 in 65.7% of the control group subjects. The difference in the post-test microbial growths of the two groups was statistically significant (p < .000). The hygienic handwashing technique taught in the therapeutic clowning and videos reduced the bacterial colonization on the preschool children's hands by 50%. Moreover, this method was effective in reducing the growth rate of coliform bacteria that indicate undesirable, poor hygiene of the hands. Considering these results, we recommend that pediatric healthcare professionals use entertaining methods such as those involving clowns to teach and guide children regarding hygienic handwashing techniques.

Bactericidal and Virucidal Activity of Povidone-Iodine and Chlorhexidine Gluconate Cleansers in an In Vivo Hand Hygiene Clinical Simulation Study.

IntroductionStandard in vitro and in vivo tests help demonstrate efficacy of hand hygiene products; however, there is no standard in vivo test method for viruses. We investigated the bactericidal and virucidal efficacy of povidone-iodine (PVP-I) 7.5% scalp and skin cleanser, chlorhexidine gluconate (CHG) 4% hand cleanser and the reference hand wash (soft soap) in 15 healthy volunteers following European Standard EN1499 (hygienic hand wash test method for bacteria), which was adapted for virucidal testing.MethodsSeparate test series were performed for bactericidal (Escherichia coli) and virucidal [murine norovirus (MNV)] testing. After pre-washing and artificial contamination of hands with test organisms, volunteers underwent testing with 3 and 5 mL of each product for contact times of 15, 30 and 60 s according to a Latin-square randomization. The number of test organisms released from fingertips into sampling fluids was assessed before and after hand washing and mean log10 reduction factor (RF) was calculated. RFs (test-reference) were compared using a Wilcoxon–Wilcox multiple comparisons test per EN1499; efficacy was concluded if p ≤ 0.01.ResultsPVP-I 7.5% and CHG 4% cleansers both passed EN1499 requirements against E. coli, with statistically significantly greater (p ≤ 0.01) mean log10 RFs compared with reference soft soap across all tests (PVP-I: 4.09–5.27; CHG: 4.12–5.22; soap: 2.75–3.11). The experimental design using EN1499 was applicable to testing with MNV as discriminatory and reproducible results were generated. Mean log10 RFs of MNV were statistically significantly greater for PVP-I (1.57–2.57) compared with soft soap (1.24–1.62), while mean log10 RFs with CHG (0.90–1.34) were lower than for soft soap across all tests.ConclusionPVP-I 7.5% cleanser showed superior efficacy against MNV compared to soft soap and CHG 4% cleanser, while both PVP-I and CHG were superior to soft soap against E. coli. The experimental set-up may be applicable to future testing for antiviral hand washes.FundingMundipharma Manufacturing Pte Ltd.Plain Language SummaryPlain language summary available for this article.

Efficacy of different hand drying methods following hygienic hand washing practices in veterinary clinics

Efficacy of different hand drying methods following hygienic hand washing practices in veterinary clinics

Detection of Antiseptic Resistance Genes among Staphylococcus aureus Colonising Nurses and Coagulase-Negative Staphylococci Isolated from Clinical Specimens at Teaching Hospitals in Southwest of Iran

Background: The wide application of antibiotics and antiseptics for patient therapy and medical equipment and surfaces disinfection has resulted in the emergence of resistant microorganisms. Staphylococcus aureus and coagulase-negative Staphylococci (CoNS) are found as a part of the normal resident flora in human so that up to two-thirds of the healthy populations are permanently or transiently colonized by S. aureus and CoNS. Chlorhexidine is an antiseptic agent particularly effective against Gram-positive bacteria. It is widely used for hygienic hand wash to prevent transmission of Staphylococci nosocomial infections. The plasmid-borne qacA/B, qacC, and smr genes confer resistance to cationic antiseptic agents in S. aureus and CoNS. Objectives: The objective of the current study was to characterize the antibiotic resistance and susceptibility to quaternary ammonium compounds (QACs) in methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-sensitive coagulase-negative staphylococci (MSCoNS), and methicillin-resistant coagulase-negative Staphylococci (MRCoNS). Methods: In this study, the antibiotic susceptibility and resistance to Chlorhexidine in 120 Staphylococcal strains were evaluated by disc diffusion and Minimum inhibitory concentration (MIC) of Chlorhexidine gluconate (CHG) methods, respectively. The MICs of CHG were determined in triplicate by broth micro-dilution, and the presence of mecA, qacA/B, qacC, and smr genes was examined by PCR assay. Results: Of total 60 S. aureus isolates, 51 (85%) were MRSA, and of 60 CoNS, 7 (11.66%) were MRCoNS. The results showed that the MIC of Chlorhexidine for all 120 isolates was 1-16 _g/mL. 15 (12.5%) isolates carried qacA/B gene, 26 (21.7%) carried qacC gene, and 38 (31.7%) carried smr gene. Conclusions: Maintenance of MRSA isolates in the attendance of low amounts of antiseptics could result in the decreased susceptibility to antiseptics.

DETERMINING FACTORS INFLUENCING IMPLEMENTATION OF HAND HYGIENE GUIDED BY WHO GUIDELINES AT THIKA LEVEL FIVE HOSPITAL

Background: Hand hygiene (HH) is any action of hand cleaning while maintaining good skin integrity. Proper HH prevents more than 50 % of hospital acquired infections. This study was carried out in May 2015. The aim of this study was to assess the level of implementation of WHO HH guidelines (moments of hand hygiene and hospital facilitation) among nurses working at Thika level five hospital. &#x0D; Methodology: A descriptive cross sectional study was carried out among nurses working at Thika level five hospital in May 2015. 140 respondents were selected using systematic random sampling. Data was collected using self-administered structured questionnaire and a standard HH checklist based on WHO guidelines. Quantitative data was analyzed using SPSS version 20 and Microsoft excel. Qualitative data was coded, categorized and analyzed using SPSS version 20. &#x0D; Results: The researcher then created a dummy variable which showed that 81 (57.9%) of the nurses were knowledgeable of hand washing recommended practices by WHO. However at 95% level of significance, nurses did not have adequate knowledge about hand washing hygiene practices as recommended by WHO guideline with a p value of 0.000. There was there was poor practice of hand hygiene practices compared to that stipulated by WHO with a p value of 0.000 at 95% level of significance. The facilitation variable showed that 40 (28.6%) of the nurses interviewed mentioned that there was adequate facilitation and access to hand hygiene but the P Value of 0.000 implies that we accept Ho. This implies that at 95% level of significance, there is inadequate facilitation of hand hygiene practices compared to that stipulated by WHO. &#x0D; Conclusions: The results of the study suggest that the TPB provides a useful framework for conceptualizing HH among nurses. Though the healthcare institution ensured availability of most facilities/materials for effective hand hygiene practice, single us towels and alcohol hand rubs were inadequate; these two are very essential for effective outcome of hand cleaning. Several factors influenced implementation of hand hygiene guidelines e.g Availability especially for single use towels and availability of alcohol hand rub. Other factors included inadequate on job training of hand hygiene and inadequate guidelines availed to the nurses. &#x0D; Recommendations The infection control department should avail chances for continuous hand hygiene education, facilitate practice and provide and environment that promotes the right attitude towards implementation of hand hygiene within the facility

Contamination of Bacteria and Associated Factors among Food Handlers Working in the Student Cafeterias of Jimma University Main Campus, Jimma, South West Ethiopia

Background: Food borne diseases continue to be a major global health problem and are the leading causes of morbidity and mortality in developing countries. Food handlers play a major role in the transmission of food borne pathogens via hands. This study aimed to assess the bacterial hand contamination and associated factors among food handlers working in the student cafeterias of Jimma University main campus. Methods and materials: A cross-sectional study was conducted from May 2012 to April 2013 among food handlers working in the student cafeterias of Jimma University main campus. The data was collected by using structured questionnaire and observational checklist. Hand rinse samples was collected from participants and microbiologically examined for the presence of potential food borne bacterial contaminants using standard laboratory methods. The data was entered into a computer and analyzed using SPSS version-16.0 software. Result: Among 230 food handlers, 114(49.6%) were tested positive for one or more potential food borne bacterial contaminants, and 73(31.7%) were tested positive for enteric pathogens. A total of 171 bacterial hand contaminants were isolated. S. aureus 54(23.5%), Klebsiella spp. 37(16.1%), E. coli 25 (10.9%), Enterobacter spp. 21(9.1%), Citrobacter spp. 10(4.3%), Serratia marcescens 6 (2.6%), Pseudomonas aeruginosa 8(3.5%), Proteus spp. 5(2.2%), Providencia rettegri 3(1.3%), and salmonella spp. 2(0.9%) were isolated with their corresponding prevalence rate. Bacterial hand contamination rate have significant association with service years (Chi-square=13.732, DF=4, P=0.008), age (χ2=11.308, P=0.010) and cleanness of outer garments (χ2=7.653, P=0.006). Conclusion: The findings of this study emphasized the importance of food handlers’ hands as a potential vector for potential food borne bacterial contaminants which could constitute a potential risk to food borne outbreaks. New employees and young and inexperienced food handlers should be well trained on personal hygienic practices pointing out on the importance of hand hygiene and appropriate hand washing techniques.

Assessment of Bacterial Hand Contamination and Associated Factors among Food Handlers Working in the Student Cafeterias of Jimma Main Campus, Jimma, South West Ethiopia

Background: Food borne diseases continue to be a major global health problem and are the leading causes of morbidity and mortality in developing countries. Food handlers play a major role in the transmission of food borne pathogens via hands. This study aimed to assess the bacterial hand contamination and associated factors among food handlers working in the student cafeterias of Jimma University main campus. Methods and materials: A cross-sectional study was conducted from May 2012 to April 2013 among food handlers working in the student cafeterias of Jimma University main campus. The data was collected by using structured questionnaire and observational checklist. Hand rinse samples was collected from participants and microbiologically examined for the presence of potential food borne bacterial contaminants using standard laboratory methods. The data was entered into a computer and analyzed using SPSS version-16.0 software. Result: Among 230 food handlers, 114(49.6%) were tested positive for one or more potential food borne bacterial contaminants, and 73(31.7%) were tested positive for enteric pathogens. A total of 171 bacterial hand contaminants were isolated. S. aureus 54(23.5%), Klebsiella spp. 37(16.1%), E. coli 25(10.9%), Enterobacter spp. 21(9.1%), Citrobacter spp. 10(4.3%), Serratia marcescens 6(2.6%), Pseudomonas aeruginosa 8(3.5%), Proteus spp. 5(2.2%), Providencia rettegri 3(1.3), and salmonella spp. 2(0.9%) were isolated with their corresponding prevalence rate. Bacterial hand contamination rate have significant association with service years (Chi-square=13.732, DF=4, P=0.008), age (χ2=11.308, P=0.010) and cleanness of outer garments (χ2=7.653, P=0.006). Conclusion: The findings of this study emphasized the importance of food handlers’ hands as a potential vector for potential food borne bacterial contaminants which could constitute a potential risk to food borne outbreaks. New employees and young and inexperienced food handlers should be well trained on personal hygienic practices pointing out on the importance of hand hygiene and appropriate hand washing techniques.

Hand-washing practices and techniques among clinical students of Bayero University Kano, Nigeria

Background: Hand-washing is an important and a single most cost-effective and practical measure that reduces the incidence of infection and cross infection among health-care providers and patients. However, compliance of health-care workers to hand hygiene guidelines are reportedly poor. It is important, therefore, to instill adequate knowledge and good attitudes and practices at the time of primary training of future health-care workers. Materials and Methods: This was a descriptive cross-sectional study carried out among randomly selected clinical students of Bayero University Kano. The questionnaires were administered to the students during their daily ward rounds and clinic sessions. Results: One hundred and thirty-seven medical and nursing students of Bayero University Kano, who were on clinical posting were studied. Sixty-three (46%) students were aware of the Global Hand-washing day ( χ 2 = 5.989, df = 2, P = 0.050). Only 16 (11.7%) students were able to state correctly the Global Hand-washing date. One hundred and thirty-one (96%) students believe that hand-washing if correctly done can reduce the risk of infection. One hundred and fourteen (83.2%) students were taught hand-washing technique ( χ 2 = 6.862, df = 1, P = 0.009). One hundred and twenty-two (89.1%) of the students use soap and water or hand rubs in washing their hands. One hundred and two (74.5%) students are not aware of the World Health Organization five moments of hand-washing hygiene. Only 13 (9.5%) students were able to mention the steps of hand-washing correctly ( χ 2 = 10.285, df = 2, P = 0.006). Eighty-six (62.8%) students adhere to the principles of hand-washing in their clinical postings ( χ 2 = 4.404, df = 1, P = 0.036). Seventy-two (52.6%) students wash their hands before handling patients ( χ 2 = 7.575, df = 1, P = 0.006), but the majority 130 (94.9%) of them wash their hands after handling patients. Conclusion: There is a need for continuous teaching of medical and nursing students on the correct hand-washing techniques and to inculcate in them the habit of hand-washing before and after touching patients. This will greatly improve the safety of the potential health-care providers and patients.

Isolation and Characterization of Microbial Contamination from Computer Accessories used in Different Department of Hazara University and Diagnostic Laboratories of District Mansehra, Pakistan

samples were collected from computer accessories used in Hazara University and different diagnostic laboratories of Mansehra, examined for the total bacterial count and maximum growths were observed. Samples were analyzed for further identification of micro-organisms such as E.coli, Klebsiella, Staph. aureus and Staph. epidermidis. These organisms were detected in the percentage of 46.66 of E. coli, 20% of Klebsiella, 16.66% of S. aureus & 16.66% of S. Epidermidis and identified on selective media, i.e. EMB agar and Mannitol salt agar. Furthermore, biochemical tests, including IMVIC Test, Catalase Test and Coagulase Tests were performed to confirm the presence of micro-organisms and their susceptibility also checked against different standard antibiotics and their zone of inhibitions were measured and noticed. E.coli showed maximum resistance of 97.36% against Erythromycin, Klebsiella showed against Amoxil + Clavolunic acid about 83.83%, Staph aureus showed against Erythromycin about 64.64% and Staph. epidermidis resistance was 90.9% against Erythromycin and Gentamycin. E.coli and Klebsiella showed maximum sensitivity for Meropenem 67.22% and 72.72% respectively while Staph. aureus and Staph. epidermidis maximum sensitivity for Vancomycin about 82.82% and 72.72% respectively. These results indicate that the computer accessories might act as environmental vehicles for the transmission of potentially pathogenic bacteria in our surroundings and also indicate the need for increasing awareness among computer users on cleaning of such surfaces or disinfection and adequate hand-washing hygiene.

Oral and Hand Hygiene Behaviour and Risk Factors among In-School Adolescents in Four Southeast Asian Countries

The aim of this study was to investigate oral and hand hygiene behaviour and risk factors among 13 to 15 year-old in-school adolescents in four Southeast Asian countries. Data were collected by self-reported questionnaire from nationally representative samples (total 13,824) of school children aged 13 to 15 years in India, Indonesia, Myanmar and Thailand. Results indicate that overall, 22.4% of school children reported sub-optimal oral hygiene (<twice a day tooth brushing), 45.2% did not always wash their hands before meals, 26.5% after toileting and 59.8% washing their hands with soap (59.8%). In multivariate analysis, male gender, health risk behaviours and lack of protective factors were associated with sub-optimal tooth brushing, and lower socioeconomic status, health risk behaviours, psychological distress and lack of protective factors were found to be associated with sub-optimal hand washing hygiene behaviour. As a conclusion, the cross-national data on oral and hand hygiene behaviour from four Southeast Asian countries found sub-optimal hygiene behaviour. Several determinants of sub-optimal hygiene behaviour were identified that can inform programmes in order to improve oral and hand hygiene behaviour of this adolescent population.

Impact of sensitization workshop on knowledge and awareness of hospital-acquired infection among nurses of a teaching hospital in India

Hospital-acquired infection (HAI) in healthcare settings is the most frequent adverse event in healthcare delivery worldwide. Hundreds of millions of patients are affected by HAI worldwide each year, leading to significant patient mortality rates and financial losses for health systems. We evaluated the impact of a sensitization workshop on knowledge and awareness of HAI among nurses in a medical college hospital in rural area of Ahmednagar district, India from March 2010 to August 2010. One hundred staff nurses, who had more than one year of experience, had attended the workshops on HAI. Pre- and post-test data was collected by a questionnaire. A significant increase in number of nurses having knowledge regarding commonly occurring HAI and routes of transmission , barrier nursing and hygienic hand washing techniques, hospital waste management (its importance and color coding), and the im-portance of an infection control team was observed after the workshop. Education and training of healthcare workers about standard infection control can reduce the extent of risks of HAI. Nurses have a critical role to play in preven-tion measures and infection control and they should have the opportunity for continuous professional development. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15960 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 77-79

Study of Knowledge, Awareness and Practices of Infection Control among ICU Staff of a Multispecialty Tertiary Level Teaching Institute of North India

Hospital infections are one of the important factors that adversely affect the image and economy of hospitals and ICU is a hotspot of infections. A descriptive and observational study was conducted in ICUs of a Multispecialty Hospital to analyze the knowledge, awareness and practices among staff about infection control.The study was based on checklist based on Ventilator Bundles and Central Line Bundles (IHI) and WHO. Whole staff of ICU was taken as sample size. A significant gap was noticed between actual practices followed and staff know-how. More than 80 per cent of staff was aware of hand hygiene moments and hand washing steps, but less than 25 per cent actually practised it. While 86 per cent of the staff claimed to wear fresh gloves, 57 per cent (239/418 observations) wore in practice. While 68 per cent claimed to follow oral care protocol, only 44 per cent actually did it. Contrary to 67 per cent who responded that they elevate the head of a patient who requires it, 49 per cent did it. And, 57 per cent of the staff followed catheter care practices as per protocol. Lack of accountability, discipline and focus on curative aspects accounts for poor performance towards infection control practices. So, through open communication, regular trainings and self-accountability, infection control standards and patient safety can be achieved.

Global Efforts to Address Severe Acute Malnutrition

476 5. C hildhood malnutrition encompasses a plethora of nutritional disorders that include stunting, underweight, wasting, severe acute malnutrition (SAM), and micronutrient deficiency disorders. Overweight and obesity, at the other end of the nutritional spectrum, are also manifestations of childhood malnutrition. Nearly 24 million children (younger than 5 years) worldwide experience SAM. The vast majority is located in Africa and Asia (8 million are in India alone). A child with SAM is 10 times more likely to die than a wellnourished child. SAM is one of the top 3 nutrition-related causes of death in children younger than 5 years. Estimates of deaths directly attributable to SAM varied from 0.5 to 2 million annually. Moderate and severe child malnutrition account for 40% to 50% of all deaths in children younger than 5 years. If the United Nations Millennium Development Goals (http://www.un.org/millennium goals) of reducing children malnutrition and mortality by 50% by 2015 are to be met, SAM needs to be prevented and controlled effectively.

Profile of Antimicrobial Resistance ofStaphylococcus aureusand Molecular Epidemiologic Characterization of Methicillin-resistantStaphylococcus aureus(MRSA) Isolated from Hands of People Using Multitude Facilities

Background: The purpose of this study was to investigate perception of hand hygiene and actual hand washing practices of people who used public facilities as well as the presence of indicator bacteria and food-borne pathogens on their hands. Data from this study will be used as a tool for public edu...