Abstract:
Background: The broader use of sodium hypochlorite in microorganisms control has been
challenged by the commercial availability of low-quality products. The problem is more prominent
in developing countries where disinfectant regulations are less stringent. Thus, this study aims to
determine the quality and surface cleaning efficacy of sodium hypochlorite products used in health
facilities of Jimma Town, Oromia Regional State, Ethiopia.
Methods and Materials: A survey-based study was conducted in Jimma town from September 1
to October 31, 2021. Twenty-seven samples were collected randomly from all health facilities
based on a joint WHO/FAO guidelines. The samples were categorized into six brands. The chief
executive officers of the healthcare facility were informed that the samples are intended only for
research purpose. The physicochemical quality and surface cleaning efficacy of the brands were
determined using the US Pharmacopeia and EPA standard methods, respectively.
Result: Only one brand (SH 01) out of six had the storage instructions, 'keep in a cool, dry area
away from direct sunshine and heat.' Instead of bleaching the red litmus paper, the SH 04 brand
turned it blue. Most of the brands differed from the label's claimed contents by a significant
percentage (59.6 on average, P = 0.0001). The SH 01 brand had the highest chlorine content
(4.64% ± 0.09%), while the SH 05 brand had the lowest (1.09% ± 0.09%). The absence of chlorine
was confirmed in the SH 04 brand (0.12% ± 0.02%). Five of the six brands were of poor quality.
Low chlorine content was shown to have a weak relationship with pH (r = 0.43, P = 0.025), as well
as storage period (r = -0.398, P = 0.040). The mean log reductions (LRs) in P. aeruginosa (LR SH
01 = 4.13, LR SH 05 =3.17, and p = 0.008) and S. aureus (LR SH 01 = 4.26, LR SH 05 =3.47, and p =
0.009) varied significantly across the SH 01 and SH 05 brands.
Conclusion and Recommendations: Five of the six brands evaluated were of poor quality. The
lowest quality brand was ineffectual at controlling microorganisms. Hence, treating healthcare-
associated infections with antibiotics becomes significantly more challenging. Regular
manufacturer inspections and a large-scale quality and efficacy evaluation of sodium hypochlorite
products are recommended
