Hygiene Tool Research Articles

P-328. Compliance of Hand Hygiene Practice among Health Care Workers in Tertiary Care Military Hospitals of Bangladesh

Abstract Background Hospital-acquired infection is still a major cause of morbidity and mortality in hospitals. Healthcare workers’ (HCWs) hands become progressively colonized with potential pathogens during their patient care and act as a vehicle for transmission of microorganisms to other patients. Hand hygiene (HH) is undisputedly one of the most effective infection control measures. Military hospitals in Bangladesh are known for better compliance of health system practice. This study aimed to evaluate HH compliance and associated factors among HCWs in two tertiary level military hospitals in Bangladesh.Table 1HH practice of Physicans Methods We conducted non-participatory observations at 02 tertiary Combined Military hospitals (CMH) at Dhaka (1650 bedded) and Jashore (500 bedded) during Oct to Dec 2021. We used the WHO’s ‘5 moments of Hand Hygiene tools’ to record HH compliance among physicians, nurses and cleaning staff. We also performed semi-structured interviews to determine the key barriers to complying with HH.Table 2HH practice of Nurses Results We observed total 172 HH opportunities. The overall HH compliance was 30.9%, highest among physicians (34.5%), followed by Nurses (25.2%). Physicians’ performance (49%) on HH practice before touching a patient was higher than the nurses (46%) but poorer (44.5%) after touching the patient than same practice of nurses (58%). Study also observed that only 24% physicians and 18% nurses practiced HH Before and after handling patient file. Responded opined that workload, shortage of time, lack of facility, distance of hand washing station, inadequate supply were the key hand hygiene barriers with soap. Insufficient supply, skin reaction, cost of product, lack of knowledge appeared. Qualitative assessment revealed that Inadequate handwashing station at wards (distance), insufficient training & orientation for HCWs, irregular monitoring and audit and lack of enforcement of IPC guidelines were key challenges at both study sites.Table 3HH practice barrier with soap Conclusion HH compliance among HCWs of study hospital was short of standard for safe patient care. Periodical training and motivation, ensuring HH supplies and enforcement of IPC guideline is needed to improve the situation.Table 4HH practice barrier of sanitizer Disclosures All Authors: No reported disclosures

Association Between Serum Levels of Perfluoroalkyl andPolyfluoroalkyl Substances and Dental Floss Use:TheDouble-Edged Sword of Dental Floss Use-A Cross-Sectional Study.

Although evidence suggests that dental floss contains perfluoroalkyl and polyfluoroalkyl substances (PFASs), it is still uncertain whether the use of dental floss contributes to an increased risk of PFAS exposure. We analysed data on serum PFAS concentrations and dental floss usage in a cohort of 6750 adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2020. In our study, we used logistic regression, a survey-weighted linear model, item response theory (IRT) scores, inverse probability weights (IPWs) and sensitivity analysis to assess the potential impact of dental floss usage on human serum PFAS levels. The analysis of six PFASs revealed that dental floss users had higher serum concentrations of perfluorooctanoic acid (PFOA) compared with non-users, while serum concentrations of other PFASs were lower. Dental floss users recorded a lower level of overall PFAS burden score compared with non-users. Sensitivity analysis showed a statistically significant increase in serum PFOA concentration among dental floss users. Our findings suggest that the use of dental floss may be associated differently with serum concentrations of specific PFASs. Among a large representative sample of U.S. adults, individuals reporting the use of dental floss had lower levels of serum PFASs overall, with the exception of PFOA, which was slightly elevated. Dental floss is an important oral hygiene tool, and further research is needed to clarify its role in PFAS exposure.

Oral Health and Quality of Life in Type 2 Diabetic Patients: Key Findings from a Romanian Study.

Background: Diabetes mellitus is associated with various oral health complications that can negatively impact quality of life. Despite evidence of the relationship between diabetes and oral health issues, limited research exists on the perceptions, behaviors, and oral health-related quality of life (OHRQoL) of diabetic patients in Romania. This study aims to evaluate self-reported oral health, knowledge, behaviors, and OHRQoL among diabetic patients in western Romania. Methods: A cross-sectional study was conducted in early 2024 at Pius Brinzeu County Emergency Hospital, Timisoara, involving 121 patients with type 2 diabetes. Data were collected using self-administered questionnaires that assessed oral health status, behaviors, and OHRQoL, with the OHIP-14 instrument employed for quality-of-life measurement. Statistical analyses included descriptive statistics, multiple linear regression, and correlation analyses to identify the predictors of oral health knowledge and OHRQoL. Results: Participants (mean age: 63.24 years; 52.1% female; 60.5% urban residents) reported significant oral health challenges. Over half (56.2%) did not visit a dentist regularly, with financial constraints identified as the primary barrier (23.5%). Oral hygiene practices were suboptimal: only 38.0% brushed twice daily, while 78.5% used fluoride toothpaste. Auxiliary hygiene tools, such as mouthwash and toothpicks, were rarely used (13.22% and 11.57%, respectively). Regression analyses identified the significant predictors of oral health knowledge, including tooth mobility (β = 0.33, p < 0.01) and brushing frequency (β = -0.18, p < 0.05). The mean OHIP-14 score (0.55) indicated a moderate impact on OHRQoL, with domains such as psychological discomfort and social disability revealing nuanced challenges. Conclusions: Diabetic patients in Romania face oral health challenges and care barriers, emphasizing the need for preventive strategies, oral health education, and integrated diabetes care. Addressing these gaps can improve oral health outcomes and overall quality of life in this vulnerable population.

Comparative study of the oral hygiene status of users of mefakia (traditional tooth cleaning method) and modern toothbrushes among patients at the Holy Bethel Dental Clinic in Addis Ababa, Ethiopia

BackgroundMefakia is a well-known traditional chewing wood used in Ethiopia to cleanse the mouth. Although mefakia is used in parallel with modern toothbrushes to improve oral hygiene, there is a gap in the literature regarding its comparative performance in removing plaque and maintaining good oral hygiene.ObjectiveThis study aimed to evaluate and compare the oral hygiene status of patients using mefakia and modern toothbrushes at the Holy Bethel Dental Clinic in Addis Ababa, Ethiopia.MethodsThis comparative cross-sectional study was conducted at the Holy Bethel Dental Clinic in Addis Ababa, Ethiopia. A total of 246 patients (123 mefakia and 123 modern toothbrush users) were included in this study. Participants were selected using a systematic random sampling method. Data on demographic characteristics, oral hygiene practices, and clinical oral health parameters, such as the calculus index, were collected through interviews and clinical examinations. Statistical analysis was performed using SPSS version 23 to compare the oral hygiene status between the two groups. The results are presented in tables, diagrams, and text.ResultsMost respondents were aged 20–39; 66.7% and 73.2% used mefakia and toothbrushes, respectively. Sixty-seven percent of the toothbrush users had good oral hygiene, whereas 65% of the mefakia users had good oral hygiene.ConclusionsThis finding suggests that mefakia and modern toothbrushes are comparable in their effectiveness in maintaining oral hygiene. Dental education should emphasize using available and affordable oral hygiene tools such as mechanical toothbrushes and fluoridated toothpaste to improve overall oral hygiene.

Comparative Analysis of Silicone Mouth Swabs with Varying Hardness Levels for Optimal Plaque Removal in Elderly Oral Care.

Silicone mouth swabs have emerged as a promising alternative to gauze, sponge brushes, and soft-bristled toothbrushes, offering a balance between gentle cleaning and effectiveness. The flexibility and softness of silicone make it a suitable material for safely cleaning the sensitive oral tissues of elderly patients. This study aims to determine the optimal hardness level of silicone that maximises cleaning effectiveness while minimising the risk of trauma to oral tissues. A pseudo-plaque was created by mixing 6.0 g of Thicken Up Clear food additive with 12.0 ml of water and food colouring, which was then spread onto a NISSIN dentoform silicone rubber sheet (simulated soft tissue) with a thickness of 2.0 mm. Silicone heads with different hardness levels - 20, 30, 40, 50, and 60 Shore A - were attached to a V.P.2000 tooth brushing machine, operating at 75 rounds per minute with a force of 1.96 N. Each swab was used to brush the surface 25 times (n = 16 for each group). A one-way analysis of variance (ANOVA) revealed a statistically significant difference in pseudo-plaque removal among the five hardness levels, with an F-value of 106.161 (degrees of freedom = 4, 75, p 0.001). The Games-Howell pairwise comparison test showed that all five silicone hardness levels differed significantly from each other in their effectiveness in removing pseudo-plaque (p 0.05). No visible simulated soft tissue damage was observed before and after brushing, as inspected with a stereomicroscope in all experiments. The silicone oral swab with a hardness level of 60 Shore A was found to maximise pseudo-plaque removal in vitro. This finding is crucial for the development of specialised oral hygiene tools tailored to the needs of the elderly population, thereby enhancing oral health and overall well-being.

The Effects of Different Hygiene Instrumentations on Titanium Implant Fixture Surfaces.

Background and objective Applying different hygiene tools for implant maintenance alters surface configurations, impacting bacterial adhesion on titanium implant surfaces and potentially leading to peri-implant diseases. This study aimed to assess the alterations in surface topography of titanium implant fixtures after utilizing hygiene instruments such as airflow; erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er, Cr: YSGG) laser; and titanium brush, under scanning electron microscope (SEM) observation. Materials and methods We employed an experimental laboratory study designfor this research, involving 20 MegaGen ST titanium implant fixtures (MegaGen Implant Co., Ltd., Seoul, Republic of Korea). These were classified into four groups: untreated/control fixtures (n=5); fixtures treated with airflow using sodium bicarbonate powder (n=5); fixtures treated with an Er, Cr: YSGG laser system at 1.5 W power and a laser pulse of 30 Hz (n=5); andfixtures treated with titanium brush operating between 300to 1000 rpm (n=5). All fixtures were then rinsed with normal saline, fixed with 2.5% glutaraldehyde, and observed under SEM. Results In the SEM analysis, at 50x magnification, there were no differences between the fixtures. However, at 1000x, 2000x, and especially at 5000x magnification, the control group surfaces appeared to have no obvious change and were quite similar, with clearer surface details. The airflow group exhibited smoother surfaces with less complex and more organized structures. The laser group displayed a more irregular and haphazard structure, revealing a rougher topography. The titanium brush group showed the areas of the implant fixture surfaces appearing smoother and flatter. Conclusions In this SEM study, the titanium brush group yielded the smoothest surfaces and the most favorable overall outcomes, highlighting its efficacy.

Comparative analyses of bacterial contamination and microbiome of broiler carcasses in wet market and industrial processing environments

The slaughtering environment is crucial for the food hygiene and safety of poultry products. Despite the global dominance of industrial processing, live bird slaughtering in wet markets persists due to cultural, religious, and economic reasons. This study aims to reveal the correlation between hygiene scales in wet markets and bacterial contamination levels on broiler carcasses, with a particular focus on pathobiont transmission risks and microbiome characteristics. Wet markets were categorized based on home-made ratings and the Hygiene and Biosecurity Assessment Tool (HABT). The study assessed total aerobic bacterial (TAB) levels, food spoilage and hygiene indicators (Pseudomonas and E. coli), foodborne pathogen Salmonella, and the microbiome of broiler carcasses, intestinal contents, and slaughtering facilities. Comparative analyses were conducted between market and industrial processing environments. TAB levels on broiler carcasses showed a significant negative correlation with hygiene scores, indicating that both HABT and home-made rating tools effectively assess and improve processing hygiene. Industrial processing consistently reduced bacterial contamination compared to wet markets. Although Salmonella spp. prevalence was lower in market-processed carcasses, the study identified significant cross-transmission of pathobionts and variations in bacterial composition with hygiene improvements. Notably, the microbiome analysis revealed overlaps in amplicon sequence variants (ASVs) between carcasses and contamination vectors, highlighting pathobiont transmission risks. The present study confirmed the scales of hygiene standards among wet markets reflect bacterial contamination on broiler carcasses. Enhancing slaughter practices to meet industrial hygiene standards is essential for reducing the transmission of foodborne pathogens and pathobionts, and improving food safety.

Implementation of a structured oral hygiene program through nursing assistant education to address non-ventilator hospital-acquired pneumonia: A quasi-experimental study.

Non-ventilator hospital-acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate oral hygiene can help mitigate NV HAP development. Hospital staff, including nursing assistants, play an important role in ensuring that these cares are completed. A quasi-experimental pre-post design was used to evaluate outcomes before and after implementation of a structured oral hygiene education program. A structured oral hygiene program was developed and implemented in a large quaternary hospital. Change in NA knowledge, attitudes, and behaviors before and after implementation of the oral hygiene program was evaluated. Retrospective patient outcomes before and after the intervention were analyzed to detect changes in NV HAP rates. Following the education, nursing assistant knowledge of recommended frequency of oral care for patients who are NPO increased (67.2% vs. 82.1%, p = 0.003). NAs were more likely to report oral hygiene tools including oral suctioning (80.8% vs. 90.2%, p = 0.005) and toothbrushes (89.3% vs. 95.3%, p = 0.031). The unadjusted incidence of NV HAP was significantly lower in the post-intervention cohort (0.25%) compared to the pre-intervention cohort (0.74%), p < 0.001. In the adjusted model, non-invasive positive pressure ventilation increased the odds of NV HAP by nearly sevenfold (AOR = 6.88, 95% CI: 3.99, 11.39). Focused education for NAs is an effective strategy to increase knowledge related to oral hygiene. Implementing a structured oral hygiene program for NAs appears to be a promising practice to decrease NV HAP.

Innovations in oral hygiene tools: a mini review on recent developments

BackgroundThis review examines advancements in oral hygiene aids and their impact on gingival and periodontal health. As periodontal diseases are widespread, effective hygiene is vital. Enhancements in traditional tools and innovations have improved oral hygiene status. Clinical evidence confirms these innovations improve gingival and periodontal health, though proper use and patient adherence are crucial.MethodologyA comprehensive literature search was conducted using MeSH terms like “Gingivitis/prevention &amp;amp; control*”, “Dental Plaque/prevention &amp;amp; control*”, “Dentifrices”, “Electrical Equipment and Supplies*”, “Toothbrushing”, “Equipment Design”, “Anti-Infective Agents/therapeutic use”, “Oils, Volatile/therapeutic use”, “Dental Devices, Home Care”, “Dentifrices*/therapeutic use”, “Vibration”, “Gingivitis*/drug therapy”, “Gingivitis*/prevention &amp;amp; control”, “Gingival Hemorrhage/prevention &amp;amp; control”, “Anti-Inflammatory Agents/pharmacology”, “Chlorhexidine/pharmacology”, “Mouthwashes/pharmacology”, “Anti-Bacterial Agents/pharmacology”, “Mouthwashes/therapeutic use”, “Anti-Infective Agents, Local*/therapeutic use”, “Mouthwashes/chemistry*”, “Plant Extracts/therapeutic use*”, “Sodium Dodecyl Sulfate/therapeutic use*”, “Treatment Outcome”, “Oral Hygiene/methods”, “Toothpastes/therapeutic use*”, “Hyaluronic Acid/therapeutic use”, “Chronic Periodontitis*/therapy”, “Periodontal Attachment Loss/therapy”, “Probiotics*/therapeutic use”, “Oral Hygiene*”, “Periodontal Index” and so on. This search utilized PubMed and Google Scholar, restricted to English-language publications from 2018 to 2024. The screening process involved reviewing titles, abstracts, and keywords, focusing on randomized clinical trials only. Inclusion criteria focused on novel innovations in conventional oral hygiene methodologies. A total of 86 randomized clinical trial articles met the inclusion criteria.ResultsRecent innovations in traditional oral hygiene tools have markedly enhanced oral hygiene levels and patient compliance. These newer innovations demonstrate substantial efficacy in plaque control and gingival health. Clinical outcomes underscore their pivotal role in improving oral hygiene standards, promoting reduced gingivitis and enhanced patient adherence to oral care regimens.ConclusionAdvanced oral hygiene aids significantly improve gingival and periodontal health. However, patient adherence and correct usage are crucial for their optimal performance. Incorporating advanced oral hygiene aids into daily practices is essential for achieving optimal periodontal health, and continuous education is necessary to ensure their effective use.

Learning from an experience, challenges and approaches in the workplace during COVID-19 pandemic: a content analysis of international documents

BackgroundThis study aims to investigate international measures for pandemic control in the workplace based on guidelines from international organizations to learn from their experiences.MethodsWe conducted a qualitative study using content analysis. The search method involved reviewing published guidelines on preventing and responding to the COVID-19 pandemic in workplaces. After the screening process, ten guidelines were included in the content analysis. During the analysis, 200 meaning codes, 49 subcategories, and eleven categories were identified. Trustworthiness criteria were utilized to ensure the accuracy and strength of the findings.ResultsEleven categories of international content during the COVID-19 pandemic were legal requirements and duties of employees and employers, structural and program changes, risk assessment, risk communication, information and training, internal and external consultation and cooperation, provision of facilities and tools for workplace hygiene, special conditions, special groups, closing and reopening workplaces, reducing contact and exposure and mental health.ConclusionsProtecting employees during a pandemic requires a multifaceted approach and strong advocacy. The operational plan for pandemic control should be developed based on the level of risk, with support tailored to employees’ conditions and needs. Cooperation among international organizations is essential to develop a standardized plan and issue comprehensive guidelines in response to health emergencies with a global perspective and local implementation, drawing from the lessons learned during the COVID-19 pandemic.

Easy to use oral hygiene tools

Easy to use oral hygiene tools

Easy to use oral hygiene tools.

Easy to use oral hygiene tools.

Transformation of information hygiene tools In the context of the Russian-Ukrainian war

Introduction. Information hygiene has become critically important in the context of the Russian-Ukrainian war. The rapid development of information technology and methods of information warfare has necessitated the adaptation of strategies to protect against disinformation and manipulative content. Relevance and purpose. The relevance of the study lies in the need to understand and improve methods of protection against information threats in the context of the ongoing war. Given the intensity of cyberattacks and the use of the latest technologies to create and spread disinformation, the study of the transformation of information hygiene is important. The protection of personal data, continuous improvement of media literacy, and the ability to choose quality media are important issues for the Ukrainian audience. The purpose of the study is to identify changes in the information hygiene tools in Ukraine since the beginning of the full-scale invasion, as well as the specifics of a set of measures to counter disinformation and destructive narratives in the context of the Russian-Ukrainian war. Particular attention is paid to the study of adaptive mechanisms for countering disinformation and destructive narratives in the context of the Russian-Ukrainian war. This study aims to identify new strategies and tools that can effectively protect the country’s information space in the face of intense confrontation. Research methods. The research was based on the analysis of scientific literature, comparison of media literacy data, case studies of media education initiatives, and expert evaluation. Results. The article analyses the evolution of online media literacy courses that have adapted to the new challenges of the information war. New methods of fact-checking and countering disinformation created by AI are considered. The concept of infodetection as a method of adapting information hygiene is explored. Conclusions. Information hygiene in Ukraine has undergone a significant transformation, adapting to the challenges of war. Raising the level of media literacy, developing specialised educational programmes and improving fact-checking methods contribute to building the society’s resilience to information threats. An important aspect is the constant change in information hygiene methods to meet new technological challenges, including the use of AI in creating disinformation.

Effectiveness of Water Flossers in Orthodontic Treatment: A Systematic Review

Background: Maintaining good oral hygiene with orthodontic appliances can be challenging, leading to plaque accumulation and complications. Traditional oral hygiene tools have limitations, and water flossers have been proposed as an effective solution. This review aims to examine the effectiveness of water flossers in orthodontic treatment by analyzing relevant studies. Methods: A systematic literature search was conducted using PubMed, Scopus, and Embase databases following PRISMA guidelines. Inclusion criteria included observational studies reporting data on the benefits of water flossers in orthodontic treatment, focusing on outcomes such as plaque formation, gingival inflammation, and periodontal diseases. Exclusion criteria included non-observational studies, meta-analyses, systematic reviews, studies in languages other than English, and studies published before 1990. Study selection and screening were performed based on relevance and eligibility. Results: The initial search yielded 740 papers, which were narrowed down through screening and exclusion criteria. Ultimately, nine comparative studies were included in the review. The included studies encompassed multiple designs and sample sizes. Data extraction included information on the study year, study design, sample size, outcome assessed, intervention details (type of water flosser used, treatment duration), and conclusions related to the effectiveness of water flossers in orthodontic treatment. Conclusion: The review suggests that water flossers can be a valuable addition to the oral hygiene routine of orthodontic patients. The studies reviewed demonstrated the effectiveness of water flossers in plaque control, reducing gingival inflammation, and minimizing bleeding compared to traditional tools like interdental brushes and string floss. However, the evidence base is still limited, and further research is needed to strengthen the findings and explore the long-term effects of water flosser use in orthodontic treatment.

Effectiveness of Salvadora persica toothbrush and Salvadora persica chewing stick in plaque and gingivitis control: a randomized control trial

BackgroundThe values of plant-based products have taken on an expanding relevance in dentistry. Salvadora persica chewing stick (miswak) has been practiced for centuries and is recommended by the World Health Organization as a customary oral hygiene tool. The therapeutic effects of S. persica chewing stick are contributed by its mechanical cleansing action, active chemicals released, or the combination of these two actions. However, the S. persica chewing stick in its natural form can be difficult to maneuver in certain parts of the mouth. This concern has inspired the innovation of the S. persica toothbrush that is designed to merge the ease of use of a toothbrush with the beneficial natural properties of S. persica preserved in its bristle. The present study aimed to compare the clinical effectiveness between S. persica toothbrush, S. persica chewing stick and the standard toothbrush in plaque and gingivitis control.MethodsIn this single-blinded and parallel randomized controlled trial, 78 participants were randomly divided into three groups to either use (i) S. persica toothbrush (MTB); (ii) S. persica chewing stick (MCS); or (iii) standard toothbrush (STB) in a standardized manner for three weeks. Plaque Index (PI) and Periodontal Inflamed Surface Area (PISA) values, measuring plaque levels and severity of gingivitis, respectively, were evaluated at baseline, one- and three-week post-interventions.ResultsThe MCS group showed a significant improvement in the mean PISA values of the anterior teeth compared to the MTB and STB groups (MCS: from 16.35 ± 10.03 to 3.41 ± 1.14; MTB: from 25.20 ± 14.01 to 3.57 ± 1.19; STB: from 26.54 ± 8.64 to 6.17 ± 0.86; p < .050). All three groups reported significant improvements (p < .001) in the plaque levels and the severity of gingivitis from baseline to three weeks after the intervention.ConclusionsFollowing correct techniques, S. persica toothbrush and chewing sticks are as effective as the standard toothbrush in plaque control and gingival health, which represent the reputed anti-plaque and anti-gingivitis properties of S. persica.Trial registrationThis clinical trial was prospectively registered in ClinicalTrials.gov with registration NCT04650685 (25/11/2020).

Siwak as a Prophetic and Evidence-Based Oral Hygiene Tool: A Qualitative Study among Islamic Scholars

Oral hygiene care and practice, siwak, which adopts Prophet Muhammad’s (Peace be upon Him, hereafter, PBUH) sunnah, remains unclear. As such, this study aims to explore and critically appraise the Prophetic practice of siwak according to Islamic literature, and in the light of current clinical evidence to clarify siwak as the oral hygiene practice prescribed by the Prophet (PBUH). Semi-structured one-to-one interviews was conducted among local contemporary Islamic scholars. The questions prepared were based on literature review and focused on toothcleaning practices of the Prophet (PBUH) as well as how the siwak was prepared and kept, as reported in documented narrations. Interview transcripts were analysed using thematic approach while content analysis of the referred narrations of hadith was made to provide a triangulation of the overall siwak use framework. The investigation revealed that horizontal tooth-brushing was highly recommended, and that al-Arak tree sticks are preferred to be 1) specifically prepared, 2) held steadily in the right hand, 3) used between two to five minutes depending on the goal, and 4) hygienically stored. It was also found that improper siwak practice may significantly suppress the clinical advantages. Thus, these findings substantiate future evidence-based guidelines on optimal oral hygiene care for siwak user based on authentic Islamic source.

Have Hand Hygiene Practices in Two Tertiary Care Hospitals, Freetown, Sierra Leone, Improved in 2023 following Operational Research in 2021?

In 2021, an operational research study in two tertiary hospitals in Freetown showed poor hand hygiene compliance. Recommended actions were taken to improve the situation. Between February-April 2023, a cross-sectional study was conducted in the same two hospitals using the World Health Organization hand hygiene tool to assess and compare hand hygiene compliance with that observed between June-August 2021. In Connaught hospital, overall hand hygiene compliance improved from 51% to 60% (p < 0.001), and this applied to both handwash actions with soap and water and alcohol-based hand rub. Significant improvements were found in all hospital departments and amongst all healthcare worker cadres. In 34 Military Hospital (34MH), overall hand hygiene compliance decreased from 40% to 32% (p < 0.001), with significant decreases observed in all departments and amongst nurses and nursing students. The improvements in Connaught Hospital were probably because of more hand hygiene reminders, better handwash infrastructure and more frequent supervision assessments, compared with 34MH where interventions were less well applied, possibly due to the extensive hospital reconstruction at the time. In conclusion, recommendations from operational research in 2021 contributed towards the improved distribution of hand hygiene reminders, better handwash infrastructure and frequent supervision assessments, which possibly led to improved hand hygiene compliance in one of the two hospitals. These actions need to be strengthened, scaled-up and guided by ongoing operational research to promote good hand hygiene practices elsewhere in the country.

Effect of light-touch intervention and associated factors to microbial contamination at small-scale pig slaughterhouses and traditional pork shops in Vietnam

Traditional pork value chains dominate the production and distribution of pork in Vietnam; however, the high level of microbiological contamination in pork may increase the risk of food-borne disease for consumers. There is limited evidence about how to feasibly and scalably reduce microbial contamination in pork sold in traditional markets. This study aimed to assess the effectiveness of light-touch interventions for changing worker behaviour in small-scale slaughterhouses and vendors at traditional pork shops, as well as to identify risk factors for pork contamination. The intervention packages consisted of providing hygiene tools and delivering a food safety training which had been designed in a participatory way and covered 10 small-scale slaughterhouses and 29 pork shops. Pig carcasses, retailed pork, contact surfaces, and hands were sampled to measure the total bacterial count (TBC) and Salmonella contamination before, three and six weeks after the intervention, and trainee practices were observed at the same time. Linear and generalized linear mixed effects models were constructed to identify risk factors for TBC and Salmonella contamination at the slaughterhouses and pork shops. The interventions at slaughterhouses and pork shops both showed a slight reduction of TBC contamination in pig carcasses and Salmonella prevalence in retailed pork, while the TBC in retailed pork decreased only marginally. For slaughterhouses, the regression model indicated that smoking or eating during slaughtering (indicating poor hygienic practices) was associated with TBC increasing, while cleaning floors and wearing boots reduced TBC contamination. For pork shops, using rough materials (cardboard or wood) to display pork was the only factor increasing TBC contamination in pork, whereas cleaning knives was associated with lower TBC. Besides, the presence of supporters and wearing aprons reduced the probability of Salmonella contamination in pork. The findings highlight the effectiveness of light-touch interventions in reducing microbial contamination in pig carcasses at small-scale slaughterhouses and pork at traditional shops over the study period.

Hand hygiene compliance and associated factors among healthcare workers in selected tertiary-care hospitals in Bangladesh

Hand hygiene (HH) is a fundamental element of patient safety. Adherence to HH among healthcare workers (HCWs) varies greatly depending on a range of factors, including risk perceptions, institutional culture, auditing mechanisms, and availability of HH supplies. This study aimed to evaluate HH compliance and associated factors among HCWs in selected tertiary-care hospitals in Bangladesh. During September 2020 to May 2021, we conducted non-participatory observations at 10 tertiary-care hospitals using the WHO's '5-moments for hand hygiene tool' to record HH compliance among physicians, nurses and cleaning staff. We also performed semi-structured interviews to determine the key barriers to complying with HH. We observed 14,668 hand hygiene opportunities. The overall HH compliance was 25.3%, the highest among nurses (28.5%), and the lowest among cleaning staff (9.9%). HCWs in public hospitals had significantly higher odds of complying with HH practices than those in private hospitals (adjusted odds ratio: 1.73, 95% CI: 1.55-1.93). The odds of performing HH after touching a patient were 3.36 times higher compared with before touching a patient (95% CI: 2.90-3.90). The reported key barriers to performing HH were insufficient supplies (57.9%), skin reactions (26.3%), workload (26.3%) and lack of facilities (22.7%). Overall, observed HH supplies were available in 81.7% of wards for physicians and 95.1% of wards for nurses, however, no designated HH facilities were found for the cleaning staff. HH compliance among HCWs fell significantly short of the standard for safe patient care. Inadequate HH supplies demonstrate a lack of prioritizing, promoting and investing in infection prevention and control.

Knowledge and Attitudes of Pregnant Women with and without Children about Fluoride and Herbal Toothpastes

Objective: Objective: Pregnant women may be vulnerable to dental caries due to their inability to fully implement oral hygiene practices. Toothpastes are main component of oral hygiene and the most important tool for the primary prevention of caries. The study aimed to examine the knowledge and attitudes of pregnant women with children (PC) and without children (PNC) about fluoride and herbal toothpastes. Methods: A self-administered and validated 20-item questionnaire was completed by a total of 219 pregnant participants, 85 PC and 134 PNC. Statistical analyses were performed using the SciPy v1.2.3. program. Results: Most of the PC (57.65%; 69.41%) and PNC (72.39%; 47.76%) participants responded with “no idea” when asked about fluoride sources and the optimal amount of fluoride added to tap water by local health authorities (p= .006). The majority of the PC (62.4%) and the PNC (47.0%) had no preference for herbal toothpastes during pregnancy (p= .03). In addition, 86.6% of the PNC showed low knowledge about the nonfluoride content of herbal toothpastes (p= .023). While 51.5% of the PNC responded with “no idea” about a preference for herbal toothpastes for their children, 56.47% of the PC stated that they might not prefer using herbal toothpastes for their children’s routine oral hygiene. Conclusion: The findings show that both PC and PNC participants had little knowledge of toothpastes and their contents. Considering that toothpastes are the most common self-applied oral hygiene tools, knowledge and awareness of fluoride and herbal toothpastes should be raised via antenatal programs.