Effects of Hand Hygiene Campaigns on Incidence of Laboratory-confirmed Influenza and Absenteeism in Schoolchildren, Cairo, Egypt

Abstract

To evaluate the effectiveness of an intensive hand hygiene campaign on reducing absenteeism caused by influenza-like illness (ILI), diarrhea, conjunctivitis, and laboratory-confirmed influenza, we conducted a randomized control trial in 60 elementary schools in Cairo, Egypt. Children in the intervention schools were required to wash hands twice each day, and health messages were provided through entertainment activities. Data were collected on student absenteeism and reasons for illness. School nurses collected nasal swabs from students with ILI, which were tested by using a qualitative diagnostic test for influenza A and B. Compared with results for the control group, in the intervention group, overall absences caused by ILI, diarrhea, conjunctivitis, and laboratory-confirmed influenza were reduced by 40%, 30%, 67%, and 50%, respectively (p<0.0001 for each illness). An intensive hand hygiene campaign was effective in reducing absenteeism caused by these illnesses.

The Impact of a School-Based Water, Sanitation, and Hygiene Program on Absenteeism, Diarrhea, and Respiratory Infection: A Matched–Control Trial in Mali

“…13 School-based randomized trials in China and Egypt found lower rates of both absenteeism and absenteeism related to certain illnesses among pupils that participated in handwashing interventions. 10,12 A handwashing trial among preschool children in Israel found no effect on overall absenteeism or absenteeism due to illness. 14 In Kenya, no overall effect of a comprehensive WASH intervention was found, although a reduction in absence was found among girls.…”

“…Our findings are comparable with research showing that school WASH interventions are associated with lower rates of self-reported diarrhea and influenza. 9,12 In addition, we found that among pupils who had been absent in the last week, the odds of reporting absence due to diarrhea was 27% lower in beneficiary schools than in comparison schools. These data are comparable with findings of reduced absence due to diarrhea and other illness after school WASH interventions.…”

“…These data are comparable with findings of reduced absence due to diarrhea and other illness after school WASH interventions. 10,12 Other studies have also found that WASH interventions can reduce other infectious diseases such as soil-transmitted helminthes. 11 However, the observed reduction in absences due to diarrhea did not lead to a reduction of all-causes absenteeism and may not have been great enough to overcome any preexisting imbalances in absence rates between the beneficiary and comparison schools.…”

“…Talat and others showed that pupils who received an intensive hand-hygiene promotional campaign were less likely to have influenza compared with pupils in control schools, while Bowen and others did not find any significant difference in rates of respiratory infection symptoms. 10,12 Children spend considerable time at school during the school year, even so, it is not known if reduced exposure to pathogens in the school environment is sufficient to reduce illness when household conditions are poor.…”

Doktor Muda Competencies: Self-efficacy and Hand Washing Demonstration Skill among School Children in Malaysia

“…School children are important agents in spreading the disease either among themselves or to the members of the family and the community. Hence, the emphasis of hand washing is very important (Talaat et al, 2011). Majority (77.4%) subjects admitted their parents did not practice the 7 steps of hand washing at home.…”