Browsing by Author "Braun L"

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    Recommendations for hand hygiene in community settings: a scoping review of current international guidelines.
    (2023-Jun-21) MacLeod C; Braun L; Caruso BA; Chase C; Chidziwisano K; Chipungu J; Dreibelbis R; Ejemot-Nwadiaro R; Gordon B; Esteves Mills J; Cumming O; Department of Disease Control, London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK.; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.; Water, Sanitation, Hygiene and Health Unit, WHO, Geneva, Switzerland.; Water and Sanitation Program, World Bank Group, Washington, District of Columbia, USA.; Social and Behavioural Science Department, Center for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria.; Department of Environmental Health and WASHTED, Malawi University of Business and Applied Sciences, Blantyre, Malawi.; Department of Disease Control, London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK clara.macleod@lshtm.ac.uk.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Hand hygiene is an important measure to prevent disease transmission. OBJECTIVE: To summarise current international guideline recommendations for hand hygiene in community settings and to assess to what extent they are consistent and evidence based. ELIGIBILITY CRITERIA: We included international guidelines with one or more recommendations on hand hygiene in community settings-categorised as domestic, public or institutional-published by international organisations, in English or French, between 1 January 1990 and 15 November 2021. DATA SOURCES: To identify relevant guidelines, we searched the WHO Institutional Repository for Information Sharing Database, Google, websites of international organisations, and contacted expert organisations and individuals. CHARTING METHODS: Recommendations were mapped to four areas related to hand hygiene: (1) effective hand hygiene; (2) minimum requirements; (3) behaviour change and (4) government measures. Recommendations were assessed for consistency, concordance and whether supported by evidence. RESULTS: We identified 51 guidelines containing 923 recommendations published between 1999 and 2021 by multilateral agencies and international non-governmental organisations. Handwashing with soap is consistently recommended as the preferred method for hand hygiene across all community settings. Most guidelines specifically recommend handwashing with plain soap and running water for at least 20 s; single-use paper towels for hand drying; and alcohol-based hand rub (ABHR) as a complement or alternative to handwashing. There are inconsistent and discordant recommendations for water quality for handwashing, affordable and effective alternatives to soap and ABHR, and the design of handwashing stations. There are gaps in recommendations on soap and water quantity, behaviour change approaches and government measures required for effective hand hygiene. Less than 10% of recommendations are supported by any cited evidence. CONCLUSION: While current international guidelines consistently recommend handwashing with soap across community settings, there remain gaps in recommendations where clear evidence-based guidance might support more effective policy and investment.
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    WASH and learn: a scoping review of health, education and gender equity outcomes of school-based water, sanitation and hygiene in low-income and middle-income countries.
    (2025-May-06) Bick S; Davies K; Mwenge M; MacLeod C; Braun L; Chipungu J; Chidziwisano K; Dreibelbis R; WASHTED Centre, Malawi University of Business and Applied Sciences, Blantyre, Malawi.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.; Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK Robert.Dreibelbis@lshtm.ac.uk.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    School-age children in low-income and middle-income countries (LMICs) face health and educational challenges due to inadequate water, sanitation and hygiene (WASH) in schools (WinS). Evidence for the impact of WinS interventions is limited and inconsistent, and previous systematic reviews have faced challenges in synthesising data due to varied interventions, study designs and outcome measures, although most do not examine this variability in more detail. This scoping review identified 83 experimental studies from 33 LMICs measuring a primary or secondary health or educational outcome among pupils, published up to November 2023, using a systematic search of seven databases and searching of reference lists of previous systematic reviews and included articles. These included 65 studies (78%) not included in previous WinS reviews and encompassed 313 intervention effects across 14 outcome domains. Interventions comprised an array of WASH technologies and approaches, often combining infrastructure and behaviour change methods and frequently integrated with other school-based initiatives like deworming. 36 studies (43%) measured only behavioural or knowledge outcomes. Our comprehensive inventory of study outcomes identified 158 unique outcome measures, with 72% measured in exactly one study. Common outcomes included parasitic infections, anthropometric measures and school absence, but approaches to measurement varied widely even for similar outcomes. Only 7% of results were disaggregated by gender, limiting assessment of differential impacts. Our findings underscore the need for standardised outcome measures in WinS research incorporating a complete definition of the assessment and aggregation approach, greater attention to gender-specific impacts, and further exploration of modalities and functions of WinS interventions alongside novel meta-analysis methods to disentangle effects of diverse intervention components.