CHAPTER ONE
1.0 Introduction
The spread of infectious disease through hand contact has been an area of major public health concern because of the frequent contact of the hand with fomites which are potential carriers of pathogenic organisms may lead to an alarming rate of outbreaks of infections transmitted by the fomites. Worldwide annually there are 1.7 million deaths from diarrhoeal diseases and 1.5 million deaths from respiratory infections (Pruss-Ustun and Covahan, 2006), these are examples of diseases which could be contracted by humans via fomites. According to (Itah, 2004), Gram positive Staphylococcus aureus, and Gram negative bacteria such as Escherichia coli, Klebsiella species, Pseudomonas species, were found to contaminate various contact surfaces including chairs, tables, windows, door handles and many other common household fixtures. The presence of these pathogenic bacteria on environmental surfaces poses a potential risk to vulnerable, immune-compromised individuals (Pruss-Ustun and Covahan, 2006).
It has been shown that hard, non-porous surfaces such as door handles have the highest bacterial transfer rates to hands (Rusin et al., 2002). In recent past, a lot of effort has been invested in emphasized hand hygiene through hand wipes and hand sanitizers (Hota, 2004). Hand wipes with higher ethanol content are more effective in not only antimicrobial activities but also remover of endospores via mechanical action (Stout et al., 2010). Even though people are commonly aware of such practices, the possibility of inaccessibility or lack of use of these practices do exist. According to Hansen and Knochel (2010) up to 60% 0f adults do not wash their hands when appropriate. People believe that microbes are only present in research laboratories, hospitals or clinics and thus they have a misleading feeling of security in other places or while touching other surfaces such as door handles (Stout et al., 2010). Lack of knowledge of the roles of micro-habitat such as door handles in dissemination of microorganisms is a threat to public health. In fact 80% of infections are spread through hand contact with hands or other objects (Reynold and Hurst, 2005).  Reynold and Hurst (2005) used an invisible fluorescent tracer for artificial contamination of public surfaces. They found that contamination from outside surfaces was transferred to 86% of exposed individual’s and 82% tracked the tracer to their home or personal belongings hours later. The viability of Gram positive and Gram negative organism under various environment conditions have been described (Noskin et al., 1995). Some microbes are infectious at very low doses and can survive for hours to weeks on nonporous surfaces, such as countertops, telephone and door handles (Reynold and Hurst, 2005).  Enterococcihave been found to survive in dry conditions and on various fabrics utilized in the health care environment. Infectious doses of pathogen may be transferred to the mouth after handling everyday contaminated objects such as the door handles. Door handles are contaminated with various types of microorganisms including varying species of bacteria and fungi and this may be a source of nocosomial infections in hospitals. Scientific information about the occurrence of microorganisms on various objects outside the health care facilities is very little and needs to be enriched in order to educate people on the necessity of improving the habit of hand washing to reduce microbial transmission.