Hand hygiene programs that include education for children, parents and day care center workers are effective at reducing the number of respiratory infections among the center’s students and the number of antibiotic prescriptions filled, according to research published in Pediatrics. Researchers said that this intervention also reduced the number of absent days for children.
Ernestina Azor-Martinez, MD, PhD, from Distrito Sanitario de Atención Primaria, Almería, Spain, wrote that the morbidity associated with respiratory infections in children aged younger than 5 years makes it one of the most common public health problems. Additionally, these illnesses are often associated with excessive antibiotic use. The risk of respiratory illness and antibiotic use are increased when these children attend day care centers, according to the researchers.
“There are studies in which researchers assess the impact of hand hygiene programs on infectious disease transmission reduction in schools and households,” the researchers added. “However, there are few recent studies that reveal their effectiveness in day care centers, specifically, those in which researchers examine hand hygiene health education importance for day care staff and parents to reduce infection transmission in day care centers.”
To examine the efficacy of a hand-washing intervention in this setting, Azor-Martienz and colleagues conducted a cluster, randomized, controlled and open study that included 911 children aged between 0 to 3 years. Children were separated into three cohorts, with two receiving education on washing with soap and water or hand sanitizer. One group received no education (control). All children attended one of 24 day care centers in Almería and were followed up after the intervention after 8 months.
The researchers observed 5,211 respiratory infections during the study. Children in the hand sanitizer group were at decreased risk of respiratory infection episodes (incidence rate ratio [IRR] = 0.77; 95% CI, 0.68-0.88) and antibiotic use (IRR = 0.69; 95% CI, 0.57-0.84) when compared with children in the control group. When children received the intervention with soap and water hand-washing information, they were more likely to have a respiratory infection (IRR = 1.21; 95% CI, 1.06-1.39) and use antibiotics (IRR = 1.31; 95% CI, 1.08-1.56) than children in the hand sanitizer group.
Respiratory infections were the cause of 5,186 missed days at the day care centers. Children educated about hand sanitizer had significantly fewer absent days when compared with both the control group and the soap and water group.
Previous research demonstrated that teaching young students how to properly wash their hands and then culture them reduced absences by 71%.
“Families from different socioeconomic levels and countries of origin as well as children who used public and private health services took part in our study, so our findings can be representative of the respiratory infection episodes in children at day care centers in our area,” Azor-Martinez and colleagues wrote. “These could be generalized in similar day care centers in Spain because most of the respiratory infection episodes were diagnosed by a doctor... These results may not be generalizable to day care centers where sociodemographic factors or infrastructure are substantially different.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.