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

被引：26
作者：
Azor-Martinez, Ernestina [1 ]
Yui-Hifume, Romy [2 ]
Munoz-Vico, Francisco J. [3 ]
Jimenez-Noguera, Esperanza [2 ]
Marie Strizzi, Jenna [4 ]
Martinez-Martinez, Irene [1 ]
Garcia-Fernandez, Llenalia [4 ,5 ]
Seijas-Vazquez, Maria L. [1 ]
Torres-Alegre, Pilar [1 ]
Fernandez-Campos, Maria A. [1 ]
Gimenez-Sanchez, Francisco [6 ]
机构：
[1] Dist Sanitario Atenc Primaria, Almeria, Spain
[2] Hosp Torrecardenas, Serv Pediat, Almeria, Spain
[3] Hosp Torrecardenas, Unidad Inmunol, Almeria, Spain
[4] Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark
[5] Seplin Soluc Estadist, Granada, Spain
[6] Inst Balmis Vacunas, Inst Hispalense Pediat, Almeria, Spain
来源：
PEDIATRICS | 2018年 / 142卷 / 05期
关键词：
RESPIRATORY-TRACT; INFECTIOUS ILLNESSES; SCHOOL ABSENTEEISM; INTERVENTION; IMPACT; RISK; TRANSMISSION; SANITIZER; INFLUENZA; HOME;
D O I：
10.1542/peds.2018-1245
中图分类号：
R72 [儿科学];
学科分类号：
100202 ;
摘要：
In this study, we show the effectiveness of hand hygiene programs (hand sanitizer versus hand-washing versus a control) in decreasing RIs in children at DCCs. 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 Almeria (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.
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页数：10
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