Rinse‐free hand wash for reducing absenteeism among preschool and school children

摘要: BACKGROUND Illness-related absenteeism is an important problem among preschool and school children for low-, middle- high- income countries. Appropriate hand hygiene one commonly investigated implemented strategy to reduce the spread of illness subsequently number days spent absent. Most strategies involve washing hands with soap water, however this associated a factors that act as barrier its use, such requiring running need dry after cleaning. An alternative method involves using rinse-free wash. This technique has benefits over traditional may prove be beneficial in reducing illness-related children. OBJECTIVES 1. To assess effectiveness due compared no washing, conventional water or other strategies. 2. determine which products are most effective (if head-to-head comparisons exist), what effect additional combination have on outcomes interest. SEARCH METHODS In February 2020 we searched CENTRAL, MEDLINE, Embase, CINAHL, 12 databases three clinical trial registries. We also reviewed reference lists included studies made direct contact lead authors collect information required. No date language restrictions were applied. SELECTION CRITERIA Randomized controlled trials (RCTs), irrespective publication status, comparing wash any form (hand rub, sanitizer, gel, foam etc.) programs (such education alone), intervention. The population interest was aged between two 18 years attending (childcare, day care, kindergarten, (primary, secondary, elementary, etc.). Primary child student reason, adverse skin reactions. DATA COLLECTION AND ANALYSIS Following standard Cochrane methods, review (out ZM, CT, CL, CS, TB), independently selected inclusion, assessed risk bias extracted relevant data. Absences absent out total days. sometimes reported raw numbers times incidence rate ratio (IRR), extracted. For event data, calculated sizes ratios (RRs) present these 95% confidence intervals (CIs). used methodological procedures expected by data analysis followed GRADE approach establish certainty findings. MAIN RESULTS includes 19 30,747 participants. conducted USA (eight studies), Spain, each China, Colombia, Finland, France, Kenya, Bangladesh, New Zealand, Sweden, Thailand. Six preschools day-care centres (children from birth < five years), remaining 13 elementary primary schools 14 years). judged at high several domains, most-notably across domains performance detection difficulty blind those delivering intervention assessing outcome. Additionally, every outcome graded low very evidence, primarily bias, well imprecision estimates inconsistency pooled estimate IRR 0.91 (95% CI 0.82 1.01; 2 studies; low-certainty evidence), indicates there little difference groups. illness, 0.69 0.97; 6 (13 per 1000) 'no rinse-free' group (16 1000). acute respiratory 0.79 0.68 0.92; (33 (42 When evaluating gastrointestinal found 0.73 0.85; 4 (six There regarding reactions RR 1.03 0.8 1.32; 3 studies, 4365 participants; evidence). Broadly, compliance appeared range moderate (9 10,749 very-low evidence); narrativley, substantial issues compliance. Overall, perception teachers students perceived positively willing continue use (3 1229 AUTHORS' CONCLUSIONS findings identified small yet potentially regimes absenteeism. However, evidence contributed conclusion according therefore uncertain. Further research required all levels schooling evaluate regimens order provide more conclusive, higher-certainty impact. considering program local setting, needs consideration current rates whether effects seen here will translate into meaningful reduction their settings.