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J Med Microbiol 56 (2007), 659-663; DOI: 10.1099/jmm.0.46867-0
© 2007 Society for General Microbiology
ISSN 1473-5644

Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study

David B. Huang1,{dagger} and Jing Zhou2

1 Division of Infectious Diseases, New Jersey Veterans Affairs Medical Center, East Orange, NJ, USA

2 Division of Infectious Diseases, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, 535EE, Houston, TX 77030, USA

Correspondence
David B. Huang
dhuang82{at}hotmail.com

Received 1 August 2006
Accepted 3 January 2007

Patients with AIDS frequently develop diarrhoeal illness. In this randomized, controlled study, 260 patients were screened for those who had not had diarrhoea in the preceding 3 months and who had received a stable highly active antiretroviral therapy regimen for at least 6 weeks prior to the study enrolment. A total of 148 patients met the inclusion criteria and were enrolled: 75 patients were randomly assigned to an intensive handwashing intervention (i.e. handwashing after defecation, after cleaning infants who had defecated, before preparing food, before eating, and before and after sex) and 73 patients were randomly assigned to the control group. Patients in both groups were called weekly by telephone to determine compliance with handwashing and to determine the number of diarrhoeal episodes for the preceding week. Patients were observed for 1 year. Patients assigned to the intensive handwashing intervention group washed their hands more frequently compared with the control group (seven vs four times a day, respectively; P <0.05) and developed fewer episodes of diarrhoeal illness (1.24±0.9 vs 2.92±0.6 new episodes of diarrhoea, respectively; P <0.001) during the 1 year observation. The most common pathogens identified in both groups in patients who developed diarrhoeal illness were Giardia lamblia, Cryptosporidium, Entamoeba histolytica and Shigella flexneri. These data suggest that intensive handwashing reduces diarrhoeal illness in patients with AIDS.

Abbreviations: HAART, highly active antiretroviral therapy.

{dagger}Present address: Department of Virology, 900 Ridgebury Road, Ridgefield, CT 06877, USA.






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