Cleaning and Disinfection Practices of Reused Alcohol-Based Hand Rub Containers in Health Care Settings: Evidence from Five Rural Districts in Uganda

Local alcohol-based hand rub (ABHR) production systems in low-resource settings, such as in health care facilities (HCFs) in low- and middle-income countries, frequently reuse containers for storing and dispensing ABHR. Cleaning/disinfection (C/D) of ABHR containers is necessary to safely reuse them...

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Published in:The American journal of tropical medicine and hygiene Vol. 112; no. 5; p. 1146
Main Authors: Tusabe, Fred, Ishida, Kanako, Ocitti, Francis, Yapswale, Sauda, Kesande, Maureen, Isabirye, Herbert, Nanyondo, Judith, Trinies, Victoria, Medley, Alexandra, Lamorde, Mohammed, Berendes, David
Format: Journal Article
Language:English
Published: United States 01.05.2025
Subjects:
Alcohols
Anti-Infective Agents, Local
Disinfection - methods
Disinfection - standards
Equipment Reuse - standards
Ethanol
Hand Disinfection - methods
Hand Disinfection - standards
Health Facilities
Humans
Rural Population
Uganda
Uganda
ISSN:1476-1645, 1476-1645
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Summary:Local alcohol-based hand rub (ABHR) production systems in low-resource settings, such as in health care facilities (HCFs) in low- and middle-income countries, frequently reuse containers for storing and dispensing ABHR. Cleaning/disinfection (C/D) of ABHR containers is necessary to safely reuse them and is an integral part of the WHO's guidelines on local ABHR production. However, HCFs may not be aware of the need for C/D; combined with suboptimal implementation, this poses a risk of contamination of ABHR. As part of district-led ABHR production in HCFs in five rural districts in Uganda, we developed a standard operating procedure (SOP) for C/D of reused ABHR containers and provided on-site training for infection prevention and control personnel. Using in-person surveys, we assessed the availability of C/D supplies and equipment and the self-reported C/D practices before and after the training. At baseline, almost all (n = 90/91) HCFs reported reusing ABHR containers; 8% and 12% of HCFs routinely had all of the key C/D materials needed for adequately cleaning and disinfecting containers using chlorine and thermal disinfection methods, respectively. HCFs that reported adequately cleaning containers per the SOP increased from 3% (n = 2) at baseline to 18% (n = 16) after the training, whereas adequate disinfection increased from 0% (n = 0) to 5% (n = 5). All HCFs that performed disinfection reported using chlorine, and none reported using thermal disinfection. Improving access to C/D supplies, providing routine mentorship, and monitoring ABHR container C/D are needed to further improve C/D practices.
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ISSN:1476-1645
1476-1645
DOI:10.4269/ajtmh.24-0189