Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water.

Journal Article (Journal Article)


To document frequency of hygiene practices of mothers and children in a shantytown in Lima, Peru.


Continuous monitoring over three 12-h sessions in households without in-house water connections to measure: (i) water and soap use of 32 mothers; (ii) frequency of interrupting faecal-hand contamination by washing; and (iii) the time until faecal-hand contamination became a possible transmission event.


During 1008 h of observation, 55% (65/119) of mothers' and 69% (37/54) of children's faecal-hand contamination events were not followed within 15 min by handwashing or bathing. Nearly 40% (67/173) of faecal-hand contamination events became possible faecal-oral transmission events. There was no difference in the time-until-transmission between mothers and children (P = 0.43). Potential transmission of faecal material to food or mouth occurred in 64% of cases within 1 h of hand contamination. Mean water usage (6.5 l) was low compared to international disaster relief standards.


We observed low volumes of water usage, inadequate handwashing, and frequent opportunities for faecal contamination and possible transmission in this water-scarce community.

Full Text

Duke Authors

Cited Authors

  • Oswald, WE; Hunter, GC; Lescano, AG; Cabrera, L; Leontsini, E; Pan, WK; Soldan, VP; Gilman, RH

Published Date

  • November 2008

Published In

Volume / Issue

  • 13 / 11

Start / End Page

  • 1421 - 1428

PubMed ID

  • 19055623

Pubmed Central ID

  • PMC4014353

Electronic International Standard Serial Number (EISSN)

  • 1365-3156

International Standard Serial Number (ISSN)

  • 1360-2276

Digital Object Identifier (DOI)

  • 10.1111/j.1365-3156.2008.02177.x


  • eng