Effectiveness of a Hand Hygiene Program at Child Care Centers: A Cluster Randomized Trial

Abstract

OBJECTIVES: Respiratory infections (RIs) are an important cause of morbidity and excessive antibiotic prescriptions in children attending day care centers (DCCs). We aimed to assess the effectiveness of an educational and hand hygiene program in DCCs and homes in reducing RI incidence and antibiotic prescriptions in children. METHODS: A cluster, randomized, controlled, and open study of 911 children aged 0 to 3 years attending 24 DCCs in Almería (Spain) with an 8-month follow-up. Two intervention groups of DCC families performed educational and hand hygiene measures, 1 with soap and water (SWG; n = 274), another with hand sanitizer (HSG; n = 339), and the control group (CG; n = 298) followed usual hand-washing procedures. RI episode rates were compared through multilevel Poisson regression models. The percentage of days missed were compared with Poisson exact tests. RESULTS: There were 5211 RI episodes registered. Children in the HSG had less risk of RI episodes (incidence rate ratio [IRR]: 0.77; 95% confidence interval [CI]: 0.68-0.88) and antibiotic prescriptions (IRR: 0.69; 95% CI: 0.57-0.84) compared with the those in the CG. Children in the SWG had a higher risk of RI episodes (IRR: 1.21; 95% CI: 1.06-1.39) and antibiotic prescriptions (IRR: 1.31; 95% CI: 1.08-1.56) than those in the HSG. Pupils missed 5186 DCC days because of RIs, and the percentage of days absent was significantly lower in the HSG compared with the CG (P < .001) and the SWG (P < .001). CONCLUSIONS: Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents, reduce absent days, RIs, and antibiotic prescriptions for these infections in children at DCCs.

Inactivation of SARS-CoV-2 by commercially available alcohol-based hand sanitizers

“…Additionally, the dynamics of SARS-CoV-2 transmission are not fully understood. While studies have shown the use of alcohol-based hand sanitizers to be correlated with the reduction of respiratory illness, 9 , 10 more evidence is needed to understand the relative impact of hand hygiene and alcohol-based hand sanitizers at preventing COVID-19 illness.…”

Infection control in child daycare centers: logistics, knowledge, and practices of caregivers

“…These programs were based on the fact that caregivers’ knowledge about infectious diseases, their modes of transmission, and infection control practices were marginal. After the implementation of these programs (mainly health education programs about hand hygiene and environmental cleaning), the infectious diseases rates among children and caregivers were reduced, enhancing the fact that level of knowledge and infection control practices among those caregivers was really poor [ 23 , 24 ].…”

Membiasakan Pola Hidup Sehat dan Bersih pada Anak Usia Dini Selama Pandemi Covid-19

“…Mencuci tangan dengan sabun merupakan salah satu kegiatan yang dapat mencegah penyakit menular pada tubuh (Clark et al, 2016). Mencuci tangan menggunakan sabun dapat mengatasi penyebaran virus, dan berbagai penyakit (Azor-Martinez et al, 2018). Pembiasaan pola hidup sehat dan bersih dilakukan terus menerus agar menjadi kebiasaan baik bagi anak.…”