期刊
ARCHIVES OF DISEASE IN CHILDHOOD
卷 101, 期 1, 页码 42-50出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/archdischild-2015-308875
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资金
- NIHR Research for Patient Benefit Grant [PB-PG-1207-15212]
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UKCRC Public Health Research Centre of Excellence
- British Heart Foundation [MR/KO232331/1]
- Cancer Research UK
- Economic and Social Research Council
- Medical Research Council
- Welsh Government
- Wellcome Trust under the auspices UK Clinical Research Collaboration
- Medical Research Council [MR/K023233/1, 1608562] Funding Source: researchfish
- National Institute for Health Research [PDF-2013-06-026, PB-PG-1207-15212] Funding Source: researchfish
- MRC [MR/K023233/1] Funding Source: UKRI
Objective To undertake a systematic review and metaanalysis to establish the effectiveness of handwashing in reducing absence and/or the spread of respiratory tract (RT) and/or gastrointestinal (GI) infection among schoolaged children and/or staff in educational settings. Design Randomised-controlled trials (RCTs). Setting Schools and other settings with a formal educational component in any country. Patients Children aged 3-11 years, and/or staff working with them. Intervention Interventions with a hand hygiene component. Main outcome measures Incidence of RT or GI infections or symptoms related to such infections; absenteeism; laboratory results of RT and/or GI infections. Results Eighteen cluster RCTs were identified; 13 school-based, 5 in child day care facilities or preschools. Studies were heterogeneous and had significant quality issues including small numbers of clusters and participants and inadequate randomisation. Individual study results suggest interventions may reduce children's absence, RT infection incidence and symptoms, and laboratory confirmed influenza-like illness. Evidence of impact on GI infection or symptoms was equivocal. Conclusions Studies are generally not well executed or reported. Despite updating existing systematic reviews and identifying new studies, evidence of the effect of hand hygiene interventions on infection incidence in educational settings is mostly equivocal but they may decrease RT infection among children. These results update and add to knowledge about this crucial public health issue in key settings with a vulnerable population. More robust, well reported cluster RCTs which learn from existing studies, are required.
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