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Medwave 2020;20(8):e8029 doi: 10.5867/medwave.2020.08.8029
Colonización bacteriana después de la aplicación de un programa educativo: estudio cuasi experimental
Bacterial colonization after applying an educational program: A quasi-experimental study
Raul Montalvo, Salome Ochoa, Carmen Baltazar, Armida Rojas, Felix Acuña, María Custodio, Dayana Barreto, Hylen Canto, Nilda Cárdenas, Néstor Flores
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Palabras clave: hygiene, program, infection, hands

Abstract

Introduction
Educational interventions can raise awareness and understanding in population groups and may help to achieve changes in behavior.

Objective
To determine if the educational handwashing program applied to high-school students reduces the colonization of infectious bacteria on the hands.

Methods
A non-randomized quasi-experimental study was carried out using consecutive sampling of the students of the last year of high-school who were divided into an intervention group and a control group. Data were obtained before and after the implementation of the educational program. Samples were taken from the dominant hand for bacterial culture, and a questionnaire was applied that assessed knowledge of hand hygiene before and after the program. The program was aimed at improving the level of understanding and attitudes of students regarding hand hygiene.

Results
Of 208 samples obtained, the most frequent agents before and after the educational program were Staphylococcus epidermidis (39% versus 23%) and Staphylococcus aureus (21% versus 15%). The average number of colonies was 236 and 183 respectively (p = 0.35).

Conclusion
The educational program managed to improve the level of understanding about hand hygiene; however, it was not enough to reduce bacterial colonization, so other behaviors such as direct supervision should be considered.


 

No English version is available for this article.

Licencia Creative Commons Esta obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.

 

Introduction
Educational interventions can raise awareness and understanding in population groups and may help to achieve changes in behavior.

Objective
To determine if the educational handwashing program applied to high-school students reduces the colonization of infectious bacteria on the hands.

Methods
A non-randomized quasi-experimental study was carried out using consecutive sampling of the students of the last year of high-school who were divided into an intervention group and a control group. Data were obtained before and after the implementation of the educational program. Samples were taken from the dominant hand for bacterial culture, and a questionnaire was applied that assessed knowledge of hand hygiene before and after the program. The program was aimed at improving the level of understanding and attitudes of students regarding hand hygiene.

Results
Of 208 samples obtained, the most frequent agents before and after the educational program were Staphylococcus epidermidis (39% versus 23%) and Staphylococcus aureus (21% versus 15%). The average number of colonies was 236 and 183 respectively (p = 0.35).

Conclusion
The educational program managed to improve the level of understanding about hand hygiene; however, it was not enough to reduce bacterial colonization, so other behaviors such as direct supervision should be considered.

Autores: Raul Montalvo[1], Salome Ochoa[1], Carmen Baltazar[1], Armida Rojas[1], Felix Acuña[1], María Custodio[1], Dayana Barreto[1], Hylen Canto[1], Nilda Cárdenas[1], Néstor Flores[1]

Filiación:
[1] Facultad de Medicina Humana, Universidad Nacional del Centro del Perú, Huancayo, Perú

E-mail: otivo3@hotmail.com

Correspondencia a:
[1] Avenida Mariscal Castilla 3909
El Tambo, Huancayo
Perú

Citación: Montalvo R, Ochoa S, Baltazar C, Rojas A, Acuña F, Custodio M, et al. Bacterial colonization after applying an educational program: A quasi-experimental study. Medwave 2020;20(8):e8029 doi: 10.5867/medwave.2020.08.8029

Fecha de envío: 14/2/2020

Fecha de aceptación: 27/8/2020

Fecha de publicación: 23/9/2020

Origen: No solicitado

Tipo de revisión: Con revisión por pares externa, por cinco árbitros a doble ciego

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  1. Mendes PME, de Jesus Mateus LV, Costa P. Does a Playful Intervention Promote Hand Hygiene? Compliance and Educator's Beliefs about Hand Hygiene at a Daycare Center. J Pediatr Nurs. 2020 Mar-Apr;51:e64-e68. | CrossRef | PubMed |
  2. World Health Organization. Disease burden and mortality estimates. Health statistics and information systems. Geneva: WHO; 2019. [On line]. | Link |
  3. United Nations International Children's Emergency Fund. The State of the World's Children 2019: Children, food and nutrition: Growing well in a changing world. New York: UNICEF; 2019. [On line]. | Link |
  4. Organización Mundial de la Salud. Enfermedades diarreicas. Ginebra: OMS; 2017. [On line]. | Link |
  5. Galiani S, Gertler P, Orsola-Vidal A. Promoting handwashing behavior in Peru: the effect of large-scale mass-media and community level interventions. World Bank Policy Res Working Paper. 2012. | CrossRef |
  6. Vishwanath R, Selvabai AP, Shanmugam P. Detection of bacterial pathogens in the hands of rural school children across different age groups and emphasizing the importance of hand wash. J Prev Med Hyg. 2019 Jun 28;60(2):E103-E108. | CrossRef | PubMed |
  7. Instituto Nacional de Estadística e Informática. Perú: Formas de Acceso al Agua y Saneamiento Básico. Lima: INEI; 2018. [On line]. | Link |
  8. Ram P. Practical Guidance for Measuring Handwashing Behavior: 2013 Update. Water and Sanitation Program, World Bank; 2013. [On line]. | Link |
  9. Briones G. Metodología de la investigación cuantitativa en las ciencias sociales. Bogotá, Colombia: ARFO; 2002:40. [On line]. | Link |
  10. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI document M100-S28. Wayne, PA: CLSI; 2018. [On line]. | Link |
  11. Null C, Stewart CP, Pickering AJ, Dentz HN, Arnold BF, Arnold CD, et al. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial. Lancet Glob Health. 2018 Mar;6(3):e316-e329. | CrossRef | PubMed |
  12. Luby SP, Rahman M, Arnold BF, Unicomb L, Ashraf S, Winch PJ, et al. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial. Lancet Glob Health. 2018 Mar;6(3):e302-e315. | CrossRef | PubMed |
  13. Pickering AJ, Davis J. Freshwater availability and water fetching distance affect child health in sub-Saharan Africa. Environ Sci Technol. 2012 Feb 21;46(4):2391-7. | CrossRef | PubMed |
  14. Willis I. (unpublished report). Sombeza Water and Sanitiation Improvement Project (SWASIP) Final Evaluation; Aga Khan University program documents 2010.
  15. Sonego IL, Huber AC, Mosler HJ. Does the implementation of hardware need software? A longitudinal study on fluoride-removal filter use in Ethiopia. Environ Sci Technol. 2013 Nov 19;47(22):12661-8. | CrossRef | PubMed |
  16. Stevens MP, Hunter JD, Ober JF, Bearman G, Edmond MB. Watching them wash: description of a hand hygiene observation program. Infect Control Hosp Epidemiol. 2010 Feb;31(2):198-9. | CrossRef | PubMed |
  17. Burns J, Maughan-Brown B, Mouzinho Â. Washing with hope: evidence of improved handwashing among children in South Africa from a pilot study of a novel soap technology. BMC Public Health. 2018 Jun 7;18(1):709. | CrossRef | PubMed |
  18. Schlegelmilch MP, Lakhani A, Saunders LD, Jhangri GS. Evaluation of water, sanitation and hygiene program outcomes shows knowledge-behavior gaps in Coast Province, Kenya. Pan Afr Med J. 2016 Mar 30;23:145. | CrossRef | PubMed |
  19. Unicomb L, Begum F, Leontsini E, Rahman M, Ashraf S, Naser AM, et al. WASH Benefits Bangladesh trial: management structure for achieving high coverage in an efficacy trial. Trials. 2018 Jul 6;19(1):359. | CrossRef | PubMed |
  20. World Health Organization. Guide to implementation: a guide to the implementation of the WHO multimodal hand hygiene improvement strategy. Geneva: WHO; 2009. [On line]. | Link |
  21. Nobile M, Conti C, Bastianelli A, Piscitelli A, Calori GM, Navone P. Promotion of hand hygiene: the experience of the orthopaedic hospital Gaetano Pini-CTO, Milan, Italy. Ann Ig. 2018 May-Jun;30(3):229-236. | CrossRef | PubMed |
  22. Lang MC. Implementation of an evidence-based hand hygiene program in elementary schools in Ghana, as part of a City-to-City partnership between Ottawa public health and KEEA health directorate. Fam Community Health. 2012 Jul-Sep;35(3):203-11. | CrossRef | PubMed |
Mendes PME, de Jesus Mateus LV, Costa P. Does a Playful Intervention Promote Hand Hygiene? Compliance and Educator's Beliefs about Hand Hygiene at a Daycare Center. J Pediatr Nurs. 2020 Mar-Apr;51:e64-e68. | CrossRef | PubMed |

World Health Organization. Disease burden and mortality estimates. Health statistics and information systems. Geneva: WHO; 2019. [On line]. | Link |

United Nations International Children's Emergency Fund. The State of the World's Children 2019: Children, food and nutrition: Growing well in a changing world. New York: UNICEF; 2019. [On line]. | Link |

Organización Mundial de la Salud. Enfermedades diarreicas. Ginebra: OMS; 2017. [On line]. | Link |

Galiani S, Gertler P, Orsola-Vidal A. Promoting handwashing behavior in Peru: the effect of large-scale mass-media and community level interventions. World Bank Policy Res Working Paper. 2012. | CrossRef |

Vishwanath R, Selvabai AP, Shanmugam P. Detection of bacterial pathogens in the hands of rural school children across different age groups and emphasizing the importance of hand wash. J Prev Med Hyg. 2019 Jun 28;60(2):E103-E108. | CrossRef | PubMed |

Instituto Nacional de Estadística e Informática. Perú: Formas de Acceso al Agua y Saneamiento Básico. Lima: INEI; 2018. [On line]. | Link |

Ram P. Practical Guidance for Measuring Handwashing Behavior: 2013 Update. Water and Sanitation Program, World Bank; 2013. [On line]. | Link |

Briones G. Metodología de la investigación cuantitativa en las ciencias sociales. Bogotá, Colombia: ARFO; 2002:40. [On line]. | Link |

Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI document M100-S28. Wayne, PA: CLSI; 2018. [On line]. | Link |

Null C, Stewart CP, Pickering AJ, Dentz HN, Arnold BF, Arnold CD, et al. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial. Lancet Glob Health. 2018 Mar;6(3):e316-e329. | CrossRef | PubMed |

Luby SP, Rahman M, Arnold BF, Unicomb L, Ashraf S, Winch PJ, et al. Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial. Lancet Glob Health. 2018 Mar;6(3):e302-e315. | CrossRef | PubMed |

Pickering AJ, Davis J. Freshwater availability and water fetching distance affect child health in sub-Saharan Africa. Environ Sci Technol. 2012 Feb 21;46(4):2391-7. | CrossRef | PubMed |

Willis I. (unpublished report). Sombeza Water and Sanitiation Improvement Project (SWASIP) Final Evaluation; Aga Khan University program documents 2010.

Sonego IL, Huber AC, Mosler HJ. Does the implementation of hardware need software? A longitudinal study on fluoride-removal filter use in Ethiopia. Environ Sci Technol. 2013 Nov 19;47(22):12661-8. | CrossRef | PubMed |

Stevens MP, Hunter JD, Ober JF, Bearman G, Edmond MB. Watching them wash: description of a hand hygiene observation program. Infect Control Hosp Epidemiol. 2010 Feb;31(2):198-9. | CrossRef | PubMed |

Burns J, Maughan-Brown B, Mouzinho Â. Washing with hope: evidence of improved handwashing among children in South Africa from a pilot study of a novel soap technology. BMC Public Health. 2018 Jun 7;18(1):709. | CrossRef | PubMed |

Schlegelmilch MP, Lakhani A, Saunders LD, Jhangri GS. Evaluation of water, sanitation and hygiene program outcomes shows knowledge-behavior gaps in Coast Province, Kenya. Pan Afr Med J. 2016 Mar 30;23:145. | CrossRef | PubMed |

Unicomb L, Begum F, Leontsini E, Rahman M, Ashraf S, Naser AM, et al. WASH Benefits Bangladesh trial: management structure for achieving high coverage in an efficacy trial. Trials. 2018 Jul 6;19(1):359. | CrossRef | PubMed |

World Health Organization. Guide to implementation: a guide to the implementation of the WHO multimodal hand hygiene improvement strategy. Geneva: WHO; 2009. [On line]. | Link |

Nobile M, Conti C, Bastianelli A, Piscitelli A, Calori GM, Navone P. Promotion of hand hygiene: the experience of the orthopaedic hospital Gaetano Pini-CTO, Milan, Italy. Ann Ig. 2018 May-Jun;30(3):229-236. | CrossRef | PubMed |

Lang MC. Implementation of an evidence-based hand hygiene program in elementary schools in Ghana, as part of a City-to-City partnership between Ottawa public health and KEEA health directorate. Fam Community Health. 2012 Jul-Sep;35(3):203-11. | CrossRef | PubMed |