Hand hygiene in low- and middle-income countries

Michael J. Loftus, Chloe Guitart, Ermira Tartari, Andrew J. Stewardson, Fatma Amer, Fernando Bellissimo-Rodrigues, Yew Fong Lee, Shaheen Mehtar, Buyiswa L. Sithole, Didier Pittet

Research output: Contribution to journalReview ArticleOtherpeer-review

64 Citations (Scopus)


A panel of experts was convened by the International Society for Infectious Diseases (ISID) to overview evidence based strategies to reduce the transmission of pathogens via the hands of healthcare workers and the subsequent incidence of hospital acquired infections with a focus on implementing these strategies in low- and middle-income countries. Existing data suggests that hospital patients in low- and middle-income countries are exposed to rates of healthcare associated infections at least 2-fold higher than in high income countries. In addition to the universal challenges to the implementation of effective hand hygiene strategies, hospitals in low- and middle-income countries face a range of unique barriers, including overcrowding and securing a reliable and sustainable supply of alcohol-based handrub. The WHO Multimodal Hand Hygiene Improvement Strategy and its associated resources represent an evidence-based framework for developing a locally-adapted implementation plan for hand hygiene promotion.

Original languageEnglish
Pages (from-to)25-30
Number of pages6
JournalInternational Journal of Infectious Diseases
Publication statusPublished - 1 Sept 2019


  • Hand hygiene
  • Infection prevention and control
  • Low- and middle-income countries

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