Handwashing and risk of respiratory infections: a quantitative systematic review

Tropical Medicine and International Health - Tập 11 Số 3 - Trang 258-267 - 2006
Tamer Samah Rabie1, Valérie Curtis1
1Department of Infectious and Tropical Diseases, The Hygiene Centre, London School of Hygiene and Tropical Medicine, London, UK.

Tóm tắt

SummaryObjective  To determine the effect of handwashing on the risk of respiratory infection.Methods  We searched PubMed, CAB Abstracts, Embase, Web of Science, and the Cochrane library for articles published before June 2004 in all languages. We had searched reference lists of all primary and review articles. Studies were included in the review if they reported the impact of an intervention to promote hand cleansing on respiratory infections. Studies relating to hospital‐acquired infections, long‐term care facilities, immuno‐compromised and elderly people were excluded. We independently evaluated all studies, and inclusion decisions were reached by consensus. From a primary list of 410 articles, eight interventional studies met the eligibility criteria.Results  All eight eligible studies reported that handwashing lowered risks of respiratory infection, with risk reductions ranging from 6% to 44% [pooled value 24% (95% CI 6–40%)]. Pooling the results of only the seven homogenous studies gave a relative risk of 1.19 (95% CI 1.12%–1.26%), implying that hand cleansing can cut the risk of respiratory infection by 16% (95% CI 11–21%).Conclusions  Handwashing is associated with lowered respiratory infection. However, studies were of poor quality, none related to developing countries, and only one to severe disease. Rigorous trials of the impact of handwashing on acute respiratory tract infection morbidity and mortality are urgently needed, especially in developing countries.

Từ khóa


Tài liệu tham khảo

Ansari SA, 1989, In vivo protocol for testing efficacy of hand‐washing agents against viruses and bacteria: experiments with rotavirus and Escherichia coli, Applied and Environmental Microbiology, 55, 3113, 10.1128/aem.55.12.3113-3118.1989

10.1128/jcm.29.10.2115-2119.1991

10.1093/infdis/146.1.47

10.2307/2533446

10.1016/S0140-6736(03)13779-8

10.1046/j.1365-3156.2002.00954.x

10.1016/0196-6553(90)90206-8

10.1097/00001648-199905000-00005

Cherry JD, 1998, Pediatric Infectious Diseases, 1666

10.1093/oxfordjournals.aje.a120957

10.1002/sim.1207

10.1016/S1473-3099(03)00606-6

Curtis V, 2001, Evidence for behaviour change following a hygiene promotion programme in West Africa, Bulletin of the World Health Organization, 79, 518

Deeks JJ, 2003, Cochrane Reviewers’ Handbook 4.2.2 [updated December 2003]; Section 8

Dyer DL, 2000, Alcohol‐free instant hand sanitizer reduces elementary school illness absenteeism, Family Medicine, 32, 633

10.1136/bmj.315.7121.1533

10.1017/S0195941700065826

10.1086/501612

10.1093/oxfordjournals.aje.a120956

10.1046/j.1365-2672.92.5s1.17.x

10.1086/514765

10.1067/mic.2002.120366

10.1093/oxfordjournals.aje.a112555

10.7326/0003-4819-88-4-463

10.1093/infdis/142.6.811

10.1067/mic.2000.107276

10.1056/NEJM197306282882601

Hoque BA, 1991, A comparison of local handwashing agents in Bangladesh, The Journal of Tropical Medicine and Hygiene, 94, 61

10.1016/S0033-3506(95)80071-9

10.1136/adc.66.2.227

10.1016/S0140-6736(03)13811-1

10.1056/NEJMoa044307

Kaltenthaler E, 1991, Faecal indicator bacteria on the hands and the effectiveness of hand‐washing in Zimbabwe, The Journal of Tropical Medicine and Hygiene, 94, 358

10.1016/0035-9203(82)90266-8

10.1177/105984059601200204

Kotch JB, 1994, Evaluation of an hygienic intervention in child day‐care centers, Pediatrics, 94, 991, 10.1542/peds.94.6.991

10.1016/S0196-6553(96)90008-5

Ladegaard MB, 1999, Hand‐hygiene and sickness among small children attending day care centers. An intervention study, Ugeskrift for Laeger, 161, 4396

10.1023/A:1022699514610

10.1017/S0950268801005829

10.1139/m75-121

10.1016/S0196-6553(00)90004-X

Master D, 1997, Scheduled hand washing in an elementary school population, Family Medicine, 29, 336

10.1016/S0168-1605(01)00666-3

10.1016/S0140-6736(96)07495-8

10.1016/S0891-5245(97)90141-3

10.1016/S0171-2985(11)80474-2

10.1016/S0035-9203(96)90507-6

10.1007/s15010-004-3036-x

10.1017/S0022172400047288

10.1542/peds.105.4.738

10.1016/S0749-3797(01)00323-3

Scott B, 2003, Protecting children from diarrhea and acute respiratory infections: the role of hand washing promotion in water and sanitation programmes, Regional Health Forum WHO South-East Asia Region, 7, 42

St Sauver J, 1998, Hygienic practices and acute respiratory illness in family and group day care homes, Public Health Reports, 113, 544

10.1093/oxfordjournals.aje.a114529

Stata Statistical Software(2003)Stata Corporation Texas.

10.1097/00006454-199908000-00004

10.1177/10598405010170050501

10.1016/S0196-6553(03)00041-5

WHO, 2002, The World Health Report 2002: Reducing Risks, Promoting Healthy Life

WHO, 2003, Update 33 – Update on Hong Kong and China, First SARS Case Reported in India

WHO, 2003, Update 47 – Studies of SARS Virus Survival, Situation in China

Thông tin
Thông tin xuất bản

Tropical Medicine and International Health

Tập 11 Số 3

258-267

Thông tin tác giả