# Baseline Characteristics of a Cluster Randomized Controlled Trial Targeting Hand Hygiene in Primary Healthcare in Burkina Faso and Mali

## TL;DR

This study reports baseline data from a trial on hand hygiene in healthcare in Burkina Faso and Mali, showing low adherence and high contamination.

## Contribution

The study provides baseline data for a cluster randomized trial on hand hygiene in primary healthcare in West Africa.

## Key findings

- Hand hygiene adherence was low at 12% among healthcare workers.
- E. coli contamination was very high in Burkina Faso (76%) and considerable in Mali (23%).
- Participants had high intention to wash hands (93%) but poor knowledge of hand hygiene moments.

## Abstract

This study presents baseline characteristics of a cluster randomized controlled trial (cRCT) on hand hygiene in primary healthcare in Burkina Faso and Mali, addressing data gaps on hand hygiene practices in these settings.

We implemented a two-arm cRCT in 48 primary healthcare facilities. Baseline data were collected (January–June 2023), followed by covariate-constrained randomization. We conducted covert hand hygiene observations, hand-rinse sampling for Escherichia coli detection, and a survey on behavioral factors among healthcare workers. The primary outcome is observed handwashing rate.

Baseline data included 309 healthcare workers. Trial arms were balanced in hand hygiene adherence, behavioral factors, and E. coli contamination. Hand hygiene adherence was low (12%). E. coli contamination was very high in Burkina Faso (76%) and considerable in Mali (23%). Participants had a high intention to wash their hands (93%) but only a quarter could name all moments for hand hygiene.

Poor hand hygiene and E. coli contamination in our setting may heighten nosocomial infection risks. Interventions should address knowledge and build on high intentions to perform hand hygiene.