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June 16, 2004

Exciting New Treatment Cuts Child Diarrhea 53%

Diarrhea is one of the leading causes of children's deaths in the developing world. Recently, villagers in Karachi, Pakistan were introduced to an exciting new treatment that, when used daily over a one-year period, reduced incidences of childhood diarrhea by over one-half. Exciting to them, certainly. Zap*Germs readers will (should?) be familiar with it, though: soap-and-water handwashing after pooping, before fixing meals and eating, and before feeding the kids.

JAMA reports this month on evidence of the power of simple soap-and-water washing to head off diarrhea. In a one-year study of 36 poor neighborhoods in Karachi, Pakistan, researchers found that kids "younger than 15 years living in households that received handwashing promotion [i.e., teaching] and plain soap had a 53% lower incidence of diarrhea...compared with children living in control neighborhoods." That's less than half as many cases of diarrhea as usual! (I bet some Pakistani moms were happy with those results.)

(For more info, videos and a quiz, check the Global Handwashing Initiative site.)

What I find especially interesting is that some of the test families used regular soap, while others were given antibacterial soap. The researchers found that while the families who used normal soap reported a 53% drop in diarrhea, "[s]imilar reductions in diarrhea were observed among children living in households receiving antibacterial soap." That means the antibacterial soap had no apparent advantage in reducing diarrhea. And besides being cheaper, regular soap doesn't foster the survival of resistant bacteria and viruses, about which the American Medical Association has expressed concern.

Dr. Alan Greene recommends that antibacterial soap and related products be reserved for specific situations:
For children who are prone to impetigo, boils, or pimples, I would recommend using an antibacterial soap. I would also recommend it for people who are exposed to a great many infectious diseases (I use it in my office)....Far more important than the choice of soap is consistent, thorough handwashing....It does take a little work, but far less than the work it would take to take care of your children during the infections you will instead prevent. [my emphasis]


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