Master of Science / Department of Hotel, Restaurant, Institutional Management & Dietetics / Elizabeth Barrett / This research created an interactive, multimedia, food safety education program on CD/ROM for fourth through sixth grade school children. The project was divided into three stages: 1) a survey to assess children's needs, 2) program development, and 3) Beta-testing the program with content experts and the targeted audience. A needs assessment survey was administered to children, 9 to 12 years of age, who were members of a 4-H, Boys and Girls Clubs, or after school program. The survey collected demographic data, food handling frequencies/practices, handwashing habits, and computer usage/media preferences. Children were found to be active in food handling/preparation and stated they knew the definition of food safety. Many, however, were unsure of the meaning of cross-contamination, how to use a thermometer, and were inconsistent with safe handwashing practices. Almost 92% of respondents reported using the computer daily, weekly, or monthly and 91% liked using the computer for learning. To facilitate design of the food safety education program, current food safety education programs were reviewed. At the time, there were limited numbers of programs directed at children and even fewer computer-based. A multimedia specialist assisted in the creation of the food safety education program on CD/ROM titled, "Kid Chef and the Clean Kitchen Crew." The program was divided into four chapters: 1) food safety and foodborne illness, 2) handwashing importance and handwashing techniques, 3) foodborne pathogens, and 4) food safety practices from purchase to cooking to serving. Interactive and multimedia components were used throughout the program. Beta-testing with experts from food safety, multimedia, education, extension, and technology ensured that the program was factual and appropriate for fourth through sixth grade students. Additional Beta-testing with ten children in the targeted age group illustrated acceptance, ease of understanding, and navigation. Changes were made prior to each subsequent critique. The reviewers and target audience indicated the CD format was acceptable for presenting food safety education. Recommendations included increasing the amount of animation, video clips, questions, and translation into Spanish. It is further suggested that the program be tested for effectiveness via a pre/post test design.

O uso das preparações alcoólicas ainda suscita questionamentos e influencia na segurança do cuidado em saúde. Os aspectos relacionados à aceitação e tolerância destes produtos são determinantes para melhoria da prática de higiene das mãos (HM). Diante do exposto, objetivou-se avaliar a utilização de duas preparações alcoólicas na HM segundo a Estratégia Multimodal da Organização Mundial da Saúde (OMS). Trata-se de um estudo com delineamento cross-over, randomizado, duplo-cego, realizado com profissionais de enfermagem por meio de entrevistas e avaliações objetivas das condições das mãos. Utilizaram-se duas preparações alcoólicas distintas, sendo uma formulação recomendada pela OMS (handrub) e a outra fornecida pela instituição em estudo (álcool gel). Nesse sentido, foi possível avaliar as características dos produtos que influenciam a sua aceitação e tolerância nas mãos dos profissionais. Na elaboração do banco de dados realizou-se dupla digitação e a análise no Statistical Package of Social Science (SPSS). Totalizou-se 42 profissionais de enfermagem, com predominância de mulheres (36; 85,7%), faixa etária entre 36 e 45 anos (14; 33,4%) e pertencentes à categoria de técnico e auxiliar de enfermagem (32; 76,2%). Quantos aos aspectos que influenciam a tolerância da pele, a maioria dos participantes referiu ter pele clara (16; 38,1%) ou morena clara (13; 31,0%), raramente fazer uso de cremes/loções para as mãos (11; 26,2%), bem como negaram o histórico de dermatites irritativas (30 - 71,4%), atópicas (37; 88,1%) e intolerância ao álcool (42; 100,0%). Outras dificuldades relativas ao uso das preparações alcoólicas e os aspectos da prática de HM dos profissionais, antes e após a participação no estudo também foram avaliados. A preparação alcoólica na apresentação handrub não apresentou aceitabilidade positiva para apenas uma das características avaliadas (ressecamento), enquanto para o álcool gel não houve aceitabilidade para duas características (textura e velocidade de secagem). Observou-se tolerância positiva para todas as características avaliadas na utilização do handrub, entretanto observou-se uma piora no aspecto escamosidade após a utilização do álcool gel. Embora questões relativas ao treinamento e supervisão não foram exploradas estas se mostram fundamentais quando os aspectos inerentes à qualidade das preparações antissépticas foram superadas. / The use of alcoholic preparations still raises questions and influences the safety of health care. Aspects related to the acceptance and tolerance to these products are crucial to improving the practice of hand hygiene (HH). This study aimed to evaluate the use of two alcoholic preparations in HH according to the World Health Organization (WHO) Multimodal Strategy. This cross-over, randomized and double- blind study was carried out with nursing professionals through interviews and objective assessments of the conditions of the hands. Two different alcoholic preparations were used, one formulation recommended by the WHO (handrub) and the other provided by the institution under study (alcohol gel). It was possible to evaluate the characteristics of the products that influence their acceptance and tolerance in the hands of professionals. For the development of the database, double entry and analysis using the Statistical Package of Social Science (SPSS) were carried out. In total, 42 nursing professionals participated, with a predominance of women (36; 85.7%), aged 36 to 45 years (14; 33.4%) and belonging to the category of technical and auxiliary nurses (32; 76.2%). Regarding the aspects that influence the tolerance of the skin, most participants reported having light skin (16; 38.1%) or light brunette skin (13; 31.0%), rarely using creams/lotions for the hands (11; 26.2%), and denied having a history of irritant (30; 71.4%) or atopic (37; 88.1%) dermatitis and alcohol intolerance (42; 100.0%). Other difficulties related to the use of alcoholic preparations and the aspects of the practice of HH by the professionals, before and after participation in the study, were also evaluated. The alcoholic preparation as handrub did not present positive acceptability only for one of the evaluated characteristics (dryness), whereas for alcohol gel there was no acceptability for two characteristics (texture and drying rate). There was positive tolerance for all assessed characteristics in the use of Handrub, however, worsening in the squamous aspect of the skin was observed after the use of alcohol gel. Although issues related to training and supervision have not been addressed, they are key issues when features intrinsic to the quality of antiseptic preparations have been overcome.

Health care associated infections cause major challenges to the provision of health care. This isdue to the burden placed on individuals, their families, and health services. Hand hygiene actions are cost effective measures towards reducing the spread of health care associated infections and have proven very effective in preventing microbial transmission during patient care. It has beenproven that health care workers hands are the main routes of transmission of health care associated infections. Despite this, hand hygiene is still frequently overlooked by health careworkers especially in settings with limited resources. This paper therefore explores hand hygieneknowledge and behaviours of public and private health care workers in The Gambia with focuson the health belief model. The required information has been gathered from 4 public and 2 private health care facilities through the use of a questionnaire based on the WHO evaluation toolkit. Hand hygiene knowledge of health care workers corresponded with their hand hygiene behaviour. Inadequate hand hygiene performance was noted in many health care workers as wellas limited availability of hand hygiene resources from health care facilities. Private health care facilities provided better hand hygiene opportunities for their health care workers yet neither private nor public health care facilities offered adequate hand hygiene training and feedback on hand hygiene performances to their health care workers.

Master of Science / Department of Hospitality Management and Dietetics / Elizabeth B. Barrett / The Centers for Disease Control estimates that each year 48 million Americans become ill, 128,000 are hospitalized, and 3,000 die of foodborne diseases. In 2011, the CDC reported that Norovirus caused the majority of all foodborne diseases and can be eliminated with proper handwashing, which is the number one way to prevent the spread of foodborne disease. The purpose of this study was to use the Health Belief Model to determine differences in university foodservice employees’ beliefs and perceptions about handwashing and foodborne illness. The constructs of perceived susceptiblity, severity, barriers, benefits, and self-efficacy as they relate to handwashing were used to examine the differences in demographics. Instrument development included a review of literature, focus group feedback, a pilot study and a review by industry experts. The final instrument was distributed to all foodservice employees at Kansas State University using Qualtrics and pen-and-paper surveys. Frequencies, means, t-tests, ANOVA, and regression were used for data analysis and to answer research questions. Results indicated respondents who were older (above 23 years of age), full-time employees, had more than three years of experience, and were food safety certified had a higher perception of susceptibility, benefits, and self-efficacy of handwashing and its relationship to reducing foodborne illness. Perceived severity was highest among respondents with food safety certification and more than three years of experience. Supervisor/Manager category did not agree on barriers to handwashing in the workplace with other positions; however, most employees did not rate barriers as a problem. Non-white respondents showed a lower self-efficacy for ability to wash hands correctly. Results of this study highlight the need for self-efficacy focused handwashing training for first year and non-white employees.

Introdução. Os efeitos antimicrobianos dos óleos essenciais têm sido relatados na literatura científica, sobretudo referentes ao óleo essencial de Tea Tree (Melaleuca alternifolia). Tal óleo essencial tem demonstrado propriedades antissépticas e pode representar uma alternativa de um produto natural para higienização das mãos nos estabelecimentos de assistência à saúde que por ora utilizam predominantemente produtos à base de triclosan e clorexidina. Objetivo. Avaliar a eficácia da higiene das mãos na redução da carga microbiana realizada com duas formulações de sabonetes líquidos já disponíveis no mercado, contendo: óleo essencial de Tea Tree 0,3% e sabonete com triclosan na concentração de 0,5%; comparar dois procedimentos referência, sendo um da metodologia oficial (soft soap) e o outro da versão draft (soft soap + propan-2-ol). Método. Foram utilizadas as diretrizes da metodologia do Comitê Europeu de Padronização, EN 1499, indicada para avaliar a eficácia antimicrobiana de produtos para higiene das mãos. A metodologia recomenda a contaminação artificial das mãos de 12 a 15 voluntários sadios com Escherichia coli K12, seguida pela higienização das mãos com cada produto em avaliação. Ainda segundo a metodologia, os resultados além de serem comparados entre si, são comparados com um sabão de referência (soft soap), no mesmo voluntário, dia e sob condições ambientais semelhantes. Foi realizada a contagem do número de microrganismos antes (pré-valores) e após (pós-valores) cada procedimento. O fator de redução logaritimica entre os pré e pós-valores representou a atividade antimicrobiana de cada produto testado, permitindo evidenciar a eficácia dos produtos em teste comparativamente ao produto referência (soft soap seguido ou não por propan-2-ol). Resultados. Em termos de redução logarítmica, o sabonete contendo óleo essencial de Tea Tree à 0,3% foi mais eficaz do que o sabonete contendo triclosan à 0,5% (3,89 log10 x 3,59 log10), porém, pelo teste de Wilcoxon, não houve diferença estatisticamente signficante. Em relação à eficácia antimicrobiana, nenhum dos dois sabonetes apresentou desempenho superior a nenhum dos dois procedimentos referência (soft soap ou soft soap + propan-2-ol). O procedimento de higienização das mãos de referência utilizando soft soap + propan-2-ol (proposto pela versão draft da metodologia EN 1499), demonstrou-se mais eficaz do que apenas o uso do soft soap (descrito na metodologia oficial). / Introduction. The antimicrobial effects of essential oils have been reported in scientific literature, especially about essential oil of Tea Tree (Melaleuca alternifolia). This essential oil has shown antiseptic properties and may represent a natural and alternative product for hand hygiene in health care establishments that currently use products based on triclosan and chlorhexidine. Objective. Evaluate the efficacy of hand hygiene in reducing microbial load performed with two differents formulations of liquid soaps available: Tea Tree essential oil 0.3% soap and triclosan 0.5% soap; compare two references procedure, one of the official methodology (soft soap) and one of the draft version (soft soap + propan-2-ol). Method. Was used the guidelines of the European Committee for Standardization, EN1499 methodology, indicated to evaluate the efficacy of antiseptics for hand hygiene. The methodology recommends the artificial contamination of hands from 12 to 15 healthy volunteers with Escherichia coli K12 followed by washing hands with each product under evaluation. According to the methodology, results should be compared between products and with a reference soap (\"soft soap\"), in the same subject, same day and under similar environmental conditions. Were counted the number of microorganisms before (pre-values) and after (post-values) handwashing. The logarithmic reduction factor between pre-and post-values represents the antimicrobial activity of each product under test, showing the efficacy of products under test compared to the reference product (soft soap follwed or not followed by propan-2-ol). Results. In terms of logarithmic reduction, the soap containing the tea tree essential oil 0.3% was more efficacious than the soap containing 0.5% triclosan (3,89 log10 x 3,59 log10). However, the Wilcoxon test does not detected statistically significant diference. Regarding the antimicrobial efficacy, none of the two soaps showed superior performance to either references procedure (soft soap or soft soap + propan-2-ol). The procedure for reference hand hygiene using soft soap + propan-2-ol, (proposed by the draft version of the methodology EN 1499) showed to be more efficacious than use only soft soap (described in the oficial methodology).

Introdução. Os efeitos antimicrobianos dos óleos essenciais têm sido relatados na literatura científica, sobretudo referentes ao óleo essencial de Tea Tree (Melaleuca alternifolia). Tal óleo essencial tem demonstrado propriedades antissépticas e pode representar uma alternativa de um produto natural para higienização das mãos nos estabelecimentos de assistência à saúde que por ora utilizam predominantemente produtos à base de triclosan e clorexidina. Objetivo. Avaliar a eficácia da higiene das mãos na redução da carga microbiana realizada com duas formulações de sabonetes líquidos já disponíveis no mercado, contendo: óleo essencial de Tea Tree 0,3% e sabonete com triclosan na concentração de 0,5%; comparar dois procedimentos referência, sendo um da metodologia oficial (soft soap) e o outro da versão draft (soft soap + propan-2-ol). Método. Foram utilizadas as diretrizes da metodologia do Comitê Europeu de Padronização, EN 1499, indicada para avaliar a eficácia antimicrobiana de produtos para higiene das mãos. A metodologia recomenda a contaminação artificial das mãos de 12 a 15 voluntários sadios com Escherichia coli K12, seguida pela higienização das mãos com cada produto em avaliação. Ainda segundo a metodologia, os resultados além de serem comparados entre si, são comparados com um sabão de referência (soft soap), no mesmo voluntário, dia e sob condições ambientais semelhantes. Foi realizada a contagem do número de microrganismos antes (pré-valores) e após (pós-valores) cada procedimento. O fator de redução logaritimica entre os pré e pós-valores representou a atividade antimicrobiana de cada produto testado, permitindo evidenciar a eficácia dos produtos em teste comparativamente ao produto referência (soft soap seguido ou não por propan-2-ol). Resultados. Em termos de redução logarítmica, o sabonete contendo óleo essencial de Tea Tree à 0,3% foi mais eficaz do que o sabonete contendo triclosan à 0,5% (3,89 log10 x 3,59 log10), porém, pelo teste de Wilcoxon, não houve diferença estatisticamente signficante. Em relação à eficácia antimicrobiana, nenhum dos dois sabonetes apresentou desempenho superior a nenhum dos dois procedimentos referência (soft soap ou soft soap + propan-2-ol). O procedimento de higienização das mãos de referência utilizando soft soap + propan-2-ol (proposto pela versão draft da metodologia EN 1499), demonstrou-se mais eficaz do que apenas o uso do soft soap (descrito na metodologia oficial). / Introduction. The antimicrobial effects of essential oils have been reported in scientific literature, especially about essential oil of Tea Tree (Melaleuca alternifolia). This essential oil has shown antiseptic properties and may represent a natural and alternative product for hand hygiene in health care establishments that currently use products based on triclosan and chlorhexidine. Objective. Evaluate the efficacy of hand hygiene in reducing microbial load performed with two differents formulations of liquid soaps available: Tea Tree essential oil 0.3% soap and triclosan 0.5% soap; compare two references procedure, one of the official methodology (soft soap) and one of the draft version (soft soap + propan-2-ol). Method. Was used the guidelines of the European Committee for Standardization, EN1499 methodology, indicated to evaluate the efficacy of antiseptics for hand hygiene. The methodology recommends the artificial contamination of hands from 12 to 15 healthy volunteers with Escherichia coli K12 followed by washing hands with each product under evaluation. According to the methodology, results should be compared between products and with a reference soap (\"soft soap\"), in the same subject, same day and under similar environmental conditions. Were counted the number of microorganisms before (pre-values) and after (post-values) handwashing. The logarithmic reduction factor between pre-and post-values represents the antimicrobial activity of each product under test, showing the efficacy of products under test compared to the reference product (soft soap follwed or not followed by propan-2-ol). Results. In terms of logarithmic reduction, the soap containing the tea tree essential oil 0.3% was more efficacious than the soap containing 0.5% triclosan (3,89 log10 x 3,59 log10). However, the Wilcoxon test does not detected statistically significant diference. Regarding the antimicrobial efficacy, none of the two soaps showed superior performance to either references procedure (soft soap or soft soap + propan-2-ol). The procedure for reference hand hygiene using soft soap + propan-2-ol, (proposed by the draft version of the methodology EN 1499) showed to be more efficacious than use only soft soap (described in the oficial methodology).

Period poverty is a problem mainly found in places characterized by poverty. The lack of means for women and girls to properly handle their menstruation is the essence of the problem. With a lack of both quantity and quality regarding water often being an issue in such places, the hygiene is a constant challenge. Two different kinds of sanitary products are used globally, disposable and reusable. The reusable ones are often being made of cotton or other absorbent materials. Regardless the material, reusable products need cleaning between the times of use, which could be a challenge when water is not always accessible. To have a reusable sanitary pad that efficiently can be cleaned with low amounts of resources is important, especially in impoverished places. Spacerpad is a reusable sanitary pad and a part of a project at the University of Borås. The aim for the project is to reduce period poverty and to educate women and girls in menstrual hygiene management. The pad is made of polyester which does not absorb blood or water, instead the pad merely contains the fluids. This thesis was conducted as a field study in Nairobi, Kenya. The study aimed to simulate a menstruation, in order to analyze the microbial activity in two different reusable sanitary pads, during as well as after menstruation. With the influences from interviews and resources found in Kibera (a slum in Nairobi) a simulation of five days was executed, with nutrient solution instead of menstrual blood. The Spacerpad and a cotton pad were exposed to the same procedures and the effects of washing and drying were studied. The microbial activity was measured with the help of dipslides, a growth medium. The results of this study show that both Spacerpad and the cotton pad could be carriers of heavy growth of bacteria. Increasing microbial activity throughout the simulation as the days went by, ended with a dividing result after a soap wash as the final washing procedure. The pad made of cotton still carried above slight growth, compared to Spacerpad that showed almost no activity after the final cleanse. Even though the microbial activity reached high levels during the simulation, the fact that the Spacerpad can be cleaned with limited resources could be reason enough to consider the Spacerpad as a sufficiently sanitary product in an impoverished place like Kibera. / Mensfattigdom är något som vanligtvis återfinns på platser präglade av fattigdom. Bristen på medel för kvinnor och flickor att kunna hantera sin menstruation är kärnan av problemet. Med en brist i kvantitet och kvalitet på vatten som ett vanligt problem på sådana platser är det en konstant utmaning att upprätthålla sin hygien. Menstruationsskydd delas in i två olika typer, engångs- och återanvändningsbara produkter. De återanvändningsbara produkterna består ofta av bomull eller andra absorberande material. Oavsett material måste produkterna rengöras mellan användningarna, vilket kan vara en utmaning på platser där vatten inte alltid är tillgängligt. Tillgång till en återanvändningsbar binda som kan rengöras med små resurser är viktigt, speciellt på platser som kännetecknas av fattigdom. Spacerpad är en återanvändningsbar binda, framtagen som del av ett projekt vid Högskolan Borås, vars syfte är att reducera mensfattigdom och samtidigt utbilda kvinnor och flickor om menstruation och hygien. Bindan är tillverkad av polyester som inte absorberar blod eller vatten, vilket gör att bindan snarare håller vätskorna på plats. Denna uppsats gjordes som en fältstudie på plats i Nairobi, Kenya och hade som mål att simulera en menstruation. Detta för att se hur den mikrobiella aktiviteten skulle kunna se ut, under och efter en menstruation. Med influenser ur intervjuer och tillgångar från Kibera (ett slumområde i Nairobi) genomfördes simulationen med näringslösning som substitut till mensblod. I simulationen studerades effekten av tvätt och tork på den mikrobiella aktiviteten. Spacerpad och en bomullsbinda genomgick samma processer där aktiviteten mättes med hjälp av dipslides, ett växtmedium. Resultaten från denna studie visar att både Spacerpad och bomullsbindan kan vara bärare av hög tillväxt av bakterier. En ökande bakteriell aktivitet genom testdagarna, slutade med ett tudelat resultat efter en tvåltvätt som sista procedur. Bindan av bomull hade lätt tillväxt, medan Spacerpad knappt visade någon tillväxt alls efter den sista rengöringen. Den mikrobiella aktiviteten hos Spacerpad nådde höga nivåer under simulationen. Trots det så gör förmågan att kunna rengöras med låg åtgång av resurser, att den kan anses vara sanitär nog för att användas på platser präglade av fattigdom, som i Kibera.

The aim of this study was to assess the environmental sanitation conditions with regard to water, sanitation, waste management and personal hygiene of households of Dukem town in Ethiopia. A cross-sectional study design was used to conduct the research. A total of 391 households had participated in the study. Majority of households had access to improved source of drinking water. The mean per capita per day water consumption of the households was low. Two-thirds of households had improved toilet facilities. Availability of improved waste management was grossly inadequate. Two-thirds of households had washed hands after visiting toilet. Generally households had good domestic environmental sanitation conditions but it also emerged that the households were deprived from full range of access to the most essential environmental sanitation services. Therefore, the inadequate level of service to the study area could be seen as opportunity for further focused improvements towards universal access to improved environmental sanitation. / Health Studies / M.A. (Public Health)

INTRODUÇÃO: Infecções hospitalares por agentes multirresistentes (MR) acarretam custos significativos, elevada morbidade e mortalidade. A transmissão cruzada de MR é dependente da existência de pacientes e ambientes colonizados, as fontes, e da existência da via de transmissão, representada principalmente pelas mãos dos profissionais de saúde. As altas taxas de infecção hospitalar na unidade de terapia intensiva da neurologia do Hospital das Clínicas da Universidade de São Paulo e o aumento na frequência de isolamento de Acinetobacter spp. e Pseudomonas aeruginosa resistente a carbapenêmicos despertaram o interesse no estudo da colonização por estes agentes dos pacientes admitidos na unidade e o efeito de medidas de intervenção educativas na prevenção da colonização. MÉTODOS: O trabalho consistiu em um estudo quasi-experimental com três períodos (pré-intervenção educativa - PI, pós-educação-PE e pós-álcool gel - PA) nos quais eram colhidos swabs orais, axilares e retais de todos os pacientes à admissão, após três dias da admissão e semanais. Para a análise da coorte, foram excluídos os pacientes que já apresentavam colonização por PMR e AC à admissão e aqueles pacientes que, por permaneceram internados na UTIN por período inferior a três dias, tiveram culturas colhidas apenas à admissão. Entre o PI e o PE, foi realizada uma intervenção educativa que consistiu no treinamento dos profissionais de saúde visando higienização das mãos e isolamento de contato. Entre o PE e o PA, foi realizada a segunda intervenção que consistiu na disponibilização de álcool-gel para higienização das mãos na unidade. A adesão à higienização das mãos antes e após o contato com os pacientes e a adesão ao uso correto de luvas foram avaliadas antes e após cada intervenção. Calculou-se a pressão de colonização em cada período e a colonização à admissão. RESULTADOS: 1) Não houve diferenças entre os períodos em relação a idade, sexo, APACHE II, dias de internação prévios. 2) A intervenção educativa melhorou a adesão à higienização das mãos antes e após o contato com os pacientes e ao uso correto de luvas. No PA, apesar da disponibilização de álcool-gel, a adesão à higienização das mãos e ao uso correto de luvas decresceu a valores similares ao PI. 3) A probabilidade de se tornar colonizado ao longo do tempo por PMR e AC aumentou progressivamente do PI para o PE e para o PA. A densidade de incidência de colonização por PMR e AC por 1000 pacientes-dia foi de 24,8 no PI, 43,3 no PE e 67,5 no PA. 4) A pressão de colonização por PMR e AC foi diferente entre os três períodos, com média de 14,7 no PI, 38,2 no PE e 53,3 no PA. Este aumento deveu-se, principalmente, à admissão de pacientes já colonizados provenientes do Pronto Socorro. CONCLUSÃO: Para o controle da transmissão cruzada de AC e PMR são importantes intervenções educativas que visem o aumento na adesão à higienização das mãos. Entretanto, provavelmente é necessário o monitoramento da pressão de colonização e o planejamento de ações visando atuação mais abrangente, locadas nas unidades que representam fontes externas de indivíduos colonizados / Nosocomial infections by resistant pathogens are a major public health concern due to their related costs, morbidity and mortality. The cross transmission of resistant pathogens are dependent on the existence of a source, colonized patients or environment, and on carriage by the healthcare workerss hands. The increasing incidence of infections and colonization by Acinetobacter spp. (AC) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) in the Neurology intensive care unit (NICU) at Hospital das Clínicas of Universidade de São Paulo led to the study of the colonization by these pathogens and the efficacy of interventions on prevention. METHODS: This was a quasi-experimental study with three periods (pre-interventional- PI, post-educational PE and post-alcool hand rub implementation PA). In each period, patients had surveillance cultures (oropharyngeal, axillary and rectal) collected on admission, 3rd day and weekly. Patients who were colonized by CRPA or AC on admission in the NICU and patients who had just one set of cultures collected were excluded from the study. Between PI and PE, an educational intervention focused on hand hygiene and contact precautions was conducted. By the end of PE, an intervention based on the installation of alcohol hand rub dispensers was applied. Hand hygiene and glove use compliance were evaluated before and after each intervention. Colonization pressure was calculated in each period as well as colonization on admission to the ICU. RESULTS: 1) There were no differences in patients age, sex, APACHE II score and number of days in the hospital previous to NICU admission between the periods 2) The educational intervention increased hand hygiene and glove use compliance. In the PA, beside alcohol hand rub dispensers, hand hygiene and glove use compliance decreased. 3) The probability of becoming colonized by CRPA and AC during NICU stay increased over the periods. The incidence density of colonization by CPRA and AC by 1000 patient-days was 24,8 in PI, 43,3 in PE and 67,5 in PA. 4) Colonization pressure by CPRA and AC was different between periods: 14,7 in PI, 38,2 in PE and 53,3 in PA. The increase in the colonization pressure was due to the admission of patients already colonized, mainly from the Emergency room. CONCLUSIONS: Control of cross transmission of AC and CPRA requires efforts to increase hand hygiene compliance, monitoring of colonization pressure and interventions aimed at units that are sources of colonized patients

The aim of this study was to assess the environmental sanitation conditions with regard to water, sanitation, waste management and personal hygiene of households of Dukem town in Ethiopia. A cross-sectional study design was used to conduct the research. A total of 391 households had participated in the study. Majority of households had access to improved source of drinking water. The mean per capita per day water consumption of the households was low. Two-thirds of households had improved toilet facilities. Availability of improved waste management was grossly inadequate. Two-thirds of households had washed hands after visiting toilet. Generally households had good domestic environmental sanitation conditions but it also emerged that the households were deprived from full range of access to the most essential environmental sanitation services. Therefore, the inadequate level of service to the study area could be seen as opportunity for further focused improvements towards universal access to improved environmental sanitation. / Health Studies / M.A. (Public Health)