TY - JOUR

T1 - Hand Hygiene Program Decreases Gastroenteritis at Child Care Centers

T2 - A Cluster Randomized Trial

AU - Azor-Martinez, Ernestina

AU - Garcia-Fernandez, Llenalia

AU - Strizzi, Jenna Marie

AU - Cantarero-Vallejo, Maria Dolores

AU - Jimenez-Lorente, Carmen Pilar

AU - Balaguer-Martinez, Josep Vicent

AU - Torres-Alegre, Pilar

AU - Yui-Hifume, Romy

AU - Sanchez-Forte, Miguel

AU - Gimenez-Sanchez, Francisco

PY - 2020

Y1 - 2020

N2 - We aimed to assess the effectiveness of an educational and hand hygiene program in daycare centers (DCCs) and homes on acute gastroenteritis (AGE) incidence in children attending DCCs.METHODSA randomized, controlled, and open study of 911 children aged 0-3 years attending 24 DCCs in Almería (Spain) with an 8-month follow-up was employed. Two intervention groups of DCCs families performed educational and hand hygiene measures, 1 with soap and water (soap and water group; n = 274), another with hand sanitizer (hand sanitizer group [HSG]; n = 339), and the control group (CG; n = 298) followed usual handwashing procedures. We compared AGE episode rates with Poisson regression model.RESULTSseven hundred fourteen AGE episodes were registered, significant differences between HSG and CG children were found during December and January. A multivariate model was applied and the adjusted incidence rate ratios by rotavirus vaccination found significant differences when children were previously vaccinated, the children in the soap and water group had a higher risk of AGE episodes (incidence rate ratio: 1.28, 95% confidence interval:1.0-1.64), compared with those in the HSG.CONCLUSIONSThis study demonstrated that hand hygiene programs that included hand sanitizer were most effective in the winter months. Further, the largest reduction of AGE episodes occurred in the children that followed hand hygiene programs including hand sanitizer and educational measures for DCC staff, parents, and children, and were vaccinated for rotavirus.

AB - We aimed to assess the effectiveness of an educational and hand hygiene program in daycare centers (DCCs) and homes on acute gastroenteritis (AGE) incidence in children attending DCCs.METHODSA randomized, controlled, and open study of 911 children aged 0-3 years attending 24 DCCs in Almería (Spain) with an 8-month follow-up was employed. Two intervention groups of DCCs families performed educational and hand hygiene measures, 1 with soap and water (soap and water group; n = 274), another with hand sanitizer (hand sanitizer group [HSG]; n = 339), and the control group (CG; n = 298) followed usual handwashing procedures. We compared AGE episode rates with Poisson regression model.RESULTSseven hundred fourteen AGE episodes were registered, significant differences between HSG and CG children were found during December and January. A multivariate model was applied and the adjusted incidence rate ratios by rotavirus vaccination found significant differences when children were previously vaccinated, the children in the soap and water group had a higher risk of AGE episodes (incidence rate ratio: 1.28, 95% confidence interval:1.0-1.64), compared with those in the HSG.CONCLUSIONSThis study demonstrated that hand hygiene programs that included hand sanitizer were most effective in the winter months. Further, the largest reduction of AGE episodes occurred in the children that followed hand hygiene programs including hand sanitizer and educational measures for DCC staff, parents, and children, and were vaccinated for rotavirus.

U2 - 10.1016/j.ajic.2020.03.011

DO - 10.1016/j.ajic.2020.03.011

M3 - Journal article

C2 - 32303373

VL - 48

SP - 1315

EP - 1321

JO - American Journal of Infection Control

JF - American Journal of Infection Control

SN - 0196-6553

IS - 11

ER -