tetano
Editor, Senior Moderator
Trop Med Int Health. 2018 May 25. doi: 10.1111/tmi.13080. [Epub ahead of print]
[h=1]Effect of hygiene interventions on acute respiratory infections in childcare, school and domestic settings in low- and middle-income countries: a systematic review.[/h] McGuinness SL[SUP]1,[/SUP][SUP]2[/SUP], Fiona Barker S[SUP]1[/SUP], O'Toole J[SUP]1[/SUP], Cheng AC[SUP]1,[/SUP][SUP]2[/SUP], Forbes AB[SUP]1[/SUP], Sinclair M[SUP]1[/SUP], Leder K[SUP]1,[/SUP][SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] Acute respiratory infections (ARIs) disproportionately affect those living in low- and middle-income countries (LMICs). We aimed to determine if hygiene interventions delivered in childcare, school or domestic settings in LMICs effectively prevent or reduce ARIs.
[h=4]METHODS:[/h] We registered our systematic review with PROSPERO (CRD42017058239) and searched MEDLINE, EMBASE, CENTRAL and Scopus from inception to October 17, 2017 for randomised controlled trials (RCTs) examining the impact of hygiene interventions on ARI morbidity in adults and children in community-based settings in LMICs. We stratified data into childcare, school and domestic settings and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess evidence quality.
[h=4]RESULTS:[/h] We identified 14 cluster RCTs evaluating hand-hygiene interventions in LMICs with considerable heterogeneity in setting, size, intervention delivery and duration. We found reduced ARI-related absenteeism and illness in childcare settings (low- to moderate-quality evidence). In school settings, we found reduced ARI-related absenteeism and laboratory-confirmed influenza (moderate- to high-quality evidence), but no reduction in ARI illness (low-quality evidence). In domestic settings, we found reduced ARI illness and pneumonia amongst children in urban settlements (high-quality evidence) but not in rural settlements (low-quality evidence), and no effect on secondary transmission of influenza in households (moderate-quality evidence).
[h=4]CONCLUSIONS:[/h] Evidence suggests that hand hygiene interventions delivered in childcare, school and domestic settings can reduce ARI morbidity, but effectiveness varies according to setting, intervention target, and intervention compliance. Further studies are needed to develop, deliver and evaluate targeted and sustainable hygiene interventions in LMICs. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
[h=4]KEYWORDS:[/h] acute respiratory infections; behaviour-change; handwashing; hygiene; low- and middle-income countries
PMID: 29799658 DOI: 10.1111/tmi.13080
[h=1]Effect of hygiene interventions on acute respiratory infections in childcare, school and domestic settings in low- and middle-income countries: a systematic review.[/h] McGuinness SL[SUP]1,[/SUP][SUP]2[/SUP], Fiona Barker S[SUP]1[/SUP], O'Toole J[SUP]1[/SUP], Cheng AC[SUP]1,[/SUP][SUP]2[/SUP], Forbes AB[SUP]1[/SUP], Sinclair M[SUP]1[/SUP], Leder K[SUP]1,[/SUP][SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] Acute respiratory infections (ARIs) disproportionately affect those living in low- and middle-income countries (LMICs). We aimed to determine if hygiene interventions delivered in childcare, school or domestic settings in LMICs effectively prevent or reduce ARIs.
[h=4]METHODS:[/h] We registered our systematic review with PROSPERO (CRD42017058239) and searched MEDLINE, EMBASE, CENTRAL and Scopus from inception to October 17, 2017 for randomised controlled trials (RCTs) examining the impact of hygiene interventions on ARI morbidity in adults and children in community-based settings in LMICs. We stratified data into childcare, school and domestic settings and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess evidence quality.
[h=4]RESULTS:[/h] We identified 14 cluster RCTs evaluating hand-hygiene interventions in LMICs with considerable heterogeneity in setting, size, intervention delivery and duration. We found reduced ARI-related absenteeism and illness in childcare settings (low- to moderate-quality evidence). In school settings, we found reduced ARI-related absenteeism and laboratory-confirmed influenza (moderate- to high-quality evidence), but no reduction in ARI illness (low-quality evidence). In domestic settings, we found reduced ARI illness and pneumonia amongst children in urban settlements (high-quality evidence) but not in rural settlements (low-quality evidence), and no effect on secondary transmission of influenza in households (moderate-quality evidence).
[h=4]CONCLUSIONS:[/h] Evidence suggests that hand hygiene interventions delivered in childcare, school and domestic settings can reduce ARI morbidity, but effectiveness varies according to setting, intervention target, and intervention compliance. Further studies are needed to develop, deliver and evaluate targeted and sustainable hygiene interventions in LMICs. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
[h=4]KEYWORDS:[/h] acute respiratory infections; behaviour-change; handwashing; hygiene; low- and middle-income countries
PMID: 29799658 DOI: 10.1111/tmi.13080