Personal toilet after defaecation and the degree of hand contamination according to different methods used.

Transmission due to contaminated hands is one of the important routes by which diarrhoea pathogens spread. The hands commonly become contaminated while cleaning the anus after defaecation. This study deals with the commonly used methods of anal cleansing in a low socioeconomic community in Rangoon, Burma and with the degree of hand contamination that results according to the method used. A cross-sectional survey was employed for collection of behavioural and hand contamination data. The incidence of acute diarrhoea and dysentery among under-fives in this community was monitored for 1 month and was correlated with the cleaning method used by their mothers. Water was the principal method used for cleaning the anus in all age groups. No one used toilet paper and only 4 to 9% used paper other than toilet paper. The level of education seemed to be a factor in determining the use of paper or water. The hands of mothers using water were more contaminated than those using paper. However, thorough hand washing with soap and water was found to be effective in decontaminating the hands. Furthermore, there was a relation between the incidence of diarrhoea and dysentery and the method of cleaning.