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Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs

There are two common household disinfection interventions to prevent interhousehold transmission of cholera: household spraying, whereby a team disinfects cholera patients’ households, and household disinfection kits (HDKs), whereby cleaning materials are provided to cholera patients’ family members...

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Autores principales: Heylen, Camille, Ali, Cawo, Gallandat, Karin, Lantagne, Daniele, String, Gabrielle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592341/
https://www.ncbi.nlm.nih.gov/pubmed/34232914
http://dx.doi.org/10.4269/ajtmh.20-1314
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author Heylen, Camille
Ali, Cawo
Gallandat, Karin
Lantagne, Daniele
String, Gabrielle
author_facet Heylen, Camille
Ali, Cawo
Gallandat, Karin
Lantagne, Daniele
String, Gabrielle
author_sort Heylen, Camille
collection PubMed
description There are two common household disinfection interventions to prevent interhousehold transmission of cholera: household spraying, whereby a team disinfects cholera patients’ households, and household disinfection kits (HDKs), whereby cleaning materials are provided to cholera patients’ family members. Currently, both interventions lack evidence, and international agencies recommend HDK distribution; however, household spraying remains widely implemented. To understand this disconnect, we conducted 14 key informant interviews with international and national responders and a study in Haiti assessing HDK efficacy using two training modules including 20 household surveys and 327 surfaces samples before and after cleaning. During interviews, 80% of the international-level informants discussed evidence gaps for both interventions, and 60% preferred HDKs. Conversely, no national-level informants knew what an HDK was; therefore, they all preferred spraying. Informants discussed behavior changes, bleach perceptions, and implementation as facilitators and/or barriers to implementing both interventions. In households, training with demonstrations regarding the use of HDK led to increased reductions of Escherichia coli (P < 0.001) and Vibrio spp. (P < 0.001) on surfaces after participants cleaned the household compared with a hygiene promotion session only. These results emphasize the gap between the current international-level policy and the realities of cholera response programs, highlight the need for evidence to align household disinfection recommendations, and underscore the importance of the dissemination and training of responders and affected populations regarding methods to prevent intrahousehold cholera transmission.
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spelling pubmed-85923412021-11-29 Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs Heylen, Camille Ali, Cawo Gallandat, Karin Lantagne, Daniele String, Gabrielle Am J Trop Med Hyg Articles There are two common household disinfection interventions to prevent interhousehold transmission of cholera: household spraying, whereby a team disinfects cholera patients’ households, and household disinfection kits (HDKs), whereby cleaning materials are provided to cholera patients’ family members. Currently, both interventions lack evidence, and international agencies recommend HDK distribution; however, household spraying remains widely implemented. To understand this disconnect, we conducted 14 key informant interviews with international and national responders and a study in Haiti assessing HDK efficacy using two training modules including 20 household surveys and 327 surfaces samples before and after cleaning. During interviews, 80% of the international-level informants discussed evidence gaps for both interventions, and 60% preferred HDKs. Conversely, no national-level informants knew what an HDK was; therefore, they all preferred spraying. Informants discussed behavior changes, bleach perceptions, and implementation as facilitators and/or barriers to implementing both interventions. In households, training with demonstrations regarding the use of HDK led to increased reductions of Escherichia coli (P < 0.001) and Vibrio spp. (P < 0.001) on surfaces after participants cleaned the household compared with a hygiene promotion session only. These results emphasize the gap between the current international-level policy and the realities of cholera response programs, highlight the need for evidence to align household disinfection recommendations, and underscore the importance of the dissemination and training of responders and affected populations regarding methods to prevent intrahousehold cholera transmission. The American Society of Tropical Medicine and Hygiene 2021-09 2021-07-06 /pmc/articles/PMC8592341/ /pubmed/34232914 http://dx.doi.org/10.4269/ajtmh.20-1314 Text en © The American Society of Tropical Medicine and Hygiene https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Heylen, Camille
Ali, Cawo
Gallandat, Karin
Lantagne, Daniele
String, Gabrielle
Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs
title Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs
title_full Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs
title_fullStr Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs
title_full_unstemmed Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs
title_short Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs
title_sort household disinfection interventions to prevent cholera transmission: facilitators, barriers, training, and evidence needs
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592341/
https://www.ncbi.nlm.nih.gov/pubmed/34232914
http://dx.doi.org/10.4269/ajtmh.20-1314
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