Reduction in Acute Respiratory Infection Among Military Trainees: Secondary Effects of a Hygiene-Based Cluster-Randomized Trial for Skin and Soft Tissue Infection Prevention

Millar, Eugene V.; Schlett, Carey D.; Law, Natasha N.; Chen, Wei‐Ju; D’Onofrio, M.; Bennett, Jason; Lanier, Jeffrey; Tribble, David R.; Ellis, Michael W.

doi:10.1093/ofid/ofw172.936

Cited by 1 publication

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“…Fifteen trials compared hand hygiene interventions with control [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and provided sufficient data for meta-analysis. Populations included adults, children and families, in settings such as schools, childcare centres, homes, and offices.…”

Section: Hand Hygiene Versus Controlmentioning

confidence: 99%

“…Pooling of eight trials [14][15][16][17][18][19]21] for the broad outcome of acute respiratory illness (ARI) showed a 16% relative reduction in the numbers of participants with ARI in the hand hygiene group (risk ratio (RR) 0.84, 95% CI 0.82 to 0.86) ( Figure 2). However, when considering the more strictly-defined outcomes of influenza-like illness (ILI) and laboratory-confirmed influenza (influenza) [15,16,20,[22][23][24][25][26][27][28], the results were heterogeneous and not as strongly in favour of hand hygiene (RR 0.98, 95% CI 0.85 to 1.14 for ILI; RR 0.91, 95% CI 0.61 to 1.34 for influenza).…”

Section: Hand Hygiene Versus Controlmentioning

confidence: 99%

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Physical interventions to interrupt or reduce the spread of respiratory viruses. Part 2 - Hand hygiene and other hygiene measures: systematic review and meta-analysis

Al‐Ansary

Bawazeer

Beller

et al. 2020

Preprint

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OBJECTIVE:To assess the effectiveness of hand hygiene, surface disinfecting, and other hygiene interventions in preventing or reducing the spread of illnesses from respiratory viruses. DESIGN:Update of a systematic review and meta-analysis focussing on randomised controlled trials (RCTs) and cluster-RCTs (c-RCTs) evidence only. and forward and backward citation analysis of included studies. DATA SELECTION:RCTs and c-RCTs involving people of any age, testing the use of hand hygiene methods, surface disinfection or cleaning, and other miscellaneous barrier interventions. Face masks, eye protection, and person distancing are covered in Part 1 of our systematic review. Outcomes included acute respiratory illness (ARI), influenza-like illness (ILI) or laboratory-confirmed influenza (influenza) and/or related consequences (e.g. death, absenteeism from school or work). DATA EXTRACTION AND ANALYSIS: Six authors working in pairs independentlyassessed risk of bias using the Cochrane tool and extracted data. The generalised inverse variance method was used for pooling by using the random-effects model, and results reported with risk ratios (RR) and 95% confidence intervals (CIs). RESULTS:We identified 51 eligible trials. We included 25 randomised trials comparing hand hygiene interventions with a control; 15 of these could be included in meta-analyses. We pooled 8 trials for the outcome of ARI. Hand hygiene showed a 16% relative reduction in the number of participants with ARI (RR 0.84, 95% CI 0.82 to 0.86) in the intervention group. When we considered the more strictly defined outcomes of ILI and influenza, the RR for ILI was 0.98 (95% CI 0.85 to 1.14), and for influenza the RR was 0.91 (95% CI 0.61 to 1.34). Three trials measured absenteeism. We found a 36% relative reduction in absentee numbers in the hand hygiene group (RR 0.64, 95% CI 0.58 to 0.71). Comparison of different hand hygiene interventions did not favour one intervention type over another. We found no incremental effects of combining hand hygiene with using face masks or disinfecting surfaces or objects. : medRxiv preprint CONCLUSIONS: Despite the lack of evidence for the impact of hand hygiene in reducing ILI and influenza, the modest evidence for reducing the burden of ARIs, and related absenteeism, justifies reinforcing the standard recommendation for hand hygiene measures to reduce the spread of respiratory viruses. Funding for relevant trials with an emphasis on adherence and compliance with such a measure is crucial to inform policy and global pandemic preparedness with confidence and precision. : medRxiv preprint results (see Tables 1, 2 and 3 for details of the trials, interventions and outcomes). These trials looked at interventions such as soap and water, hand sanitiser, body wash and skin wipes, with or without additional hygiene education. One trial [41] compared different frequencies of handwashing in a kindergarten and found that compulsory handwashing every hour with an alcohol-based hand gel reduced absenteeism due to ILI more than handwashing...

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