Hand-hygiene interventions reduce illness due to acute respiratory infections in childcare, school and domestic settings in low- and middle-income countries
Citation: McGuinness SL, Barker SF, O’Toole J, et al. Effect of hygiene interventions on acute respiratory infections in childcare, school and domestic settings in low- and middle-income countries: a systematic review. Tropical Medicine and International Health 2018; 23: 816-33
What is this? In general, acute respiratory infection (ARI) are more common in children, particularly in low- and middle-income countries (LMICs). Interventions that improve hygiene practices may lower this disease burden and the associated evidence may inform decision making for the COVID-19 pandemic.
In this systematic review, the authors searched for randomized trials of the effects of hygiene interventions on ARI-related outcomes in children and adults in childcare, school and domestic settings in a LMIC. They did their searches in October 2017 and identified 3 trials in childcare centres, 4 trials in schools and 7 trials in domestic settings of interventions designed to promote hygiene practices in community settings.
What works: In childcare settings, hand-hygiene interventions reduced ARI-related absenteeism and illness.
In school settings, hand-hygiene interventions reduced ARI-related absenteeism and laboratory-confirmed influenza.
In domestic settings, hand-hygiene interventions and soap reduced ARI illness and pneumonia amongst children in urban settlements.
What doesn’t work: Nothing noted.
What’s uncertain: In settings where hand-hygiene interventions did not appear to reduce ARI-related outcomes, it is uncertain if this is due to ineffective interventions or inconsistent reporting of intervention compliance.