Epidemiology and Infection

Sustained high levels of stored drinking water treatment and retention of hand-washing knowledge in rural Kenyan households following a clinic-based intervention

A. A. PARKER a1a2c1, R. STEPHENSON a1, P. L. RILEY a3, S. OMBEKI a4, C. KOMOLLEH a4, L. SIBLEY a2 and R. QUICK a1a5
a1 Center for Global Safe Water at Rollins School of Public Health, Emory University, Atlanta, GA, USA
a2 Lillian Carter Center for International Nursing at Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
a3 Coordinating Office for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
a4 CARE Kenya, Homa Bay, Kenya
a5 Foodborne and Diarrheal Diseases Branch, National Center for Infectious Diseases, CDC, Atlanta, GA, USA

Article author query
parker aa   [PubMed][Google Scholar] 
stephenson r   [PubMed][Google Scholar] 
riley pl   [PubMed][Google Scholar] 
ombeki s   [PubMed][Google Scholar] 
komolleh c   [PubMed][Google Scholar] 
sibley l   [PubMed][Google Scholar] 
quick r   [PubMed][Google Scholar] 


Nyanza Province, Kenya is characterized by poor water quality and high diarrhoea prevalence. To address these problems, nurses in a maternal and child health clinic in Homa Bay, Kenya were trained in household water chlorination with a locally available, social marketed product, and in six steps of proper hand washing. They were asked to communicate this information to their clients. Interviews immediately following the training by nurses were conducted on 220 clients, of whom 168 (76%) reported being taught both procedures during their clinic visit. After 2 weeks, free chlorine residuals were present in stored drinking water in 67 out of 98 (68%) clients' homes and, 1 year later, in 36 out of 51 (71%) clients' homes. After 2 weeks, all six hand-washing steps were correctly demonstrated by 41 (44%) out of 93 clients, and by 17 out of 51 (34%) 1 year later. This brief, practical intervention shows promise for vulnerable populations.

(Accepted November 30 2005)
(Published Online January 26 2006)

c1 National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop E-61, Atlanta, GA 30333, USA. (Email: amyaparker@gmail.com)