Raina M Phillips|Jelena Vujcic|Andrew Boscoe|Thomas Handzel|Mark Aninyasi|Susan T. Cookson|Curtis Blanton|Lauren S. Blum|Pavani K. Ram
Soap is not enough: handwashing practices and knowledge in refugee camps, Maban County, South Sudan
Centers for Disease Control and Prevention|University at Buffalo, State University of New York|Centers for Disease Control and Prevention|Centers for Disease Control and Prevention|Centers for Disease Control and Prevention|University at Buffalo, State University of New York
refugees high risk communicable diseases due overcrowding poor water sanitation hygiene conditions handwashing soap removes pathogens hands reduces disease risk hepatitis e outbreak refugee camps maban county south sudan 2012 prompted increased hygiene promotion improved provision soap handwashing stations latrines conducted study 1 year outbreak assess knowledge attitudes practices refugees maban countywe conducted cross sectional survey female heads households three refugee camps maban county performed structured observations subset households directly observe handwashing practices times possible pathogen transmissionof 600 households interviewed nearly soap available 91 reported water available always sometimes exposure handwashing promotion reported 85 respondents rinsing hands water alone commonly observed handwashing soap critical handwashing times including eating 80 rinsing vs 7 washing soap preparingcooking food 723 vs 23 toilet use 46 observed wash hands soap additional 38 rinsed water alonedespite intensive messaging regarding handwashing soap access soap water rinsing hands water alone rather washing hands soap remains common among refugees maban county practice puts continued risk communicable disease transmission qualitative research local beliefs effective messaging may help future programs tailor handwashing interventions