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      The importance of hand hygiene education on primary schoolgirls’ absence due to upper respiratory infections in Saudi Arabia : A cluster randomized controlled trial

      research-article
      , MD, , DFE, PhD, , MD, MDCM, , MPH, PhD
      Saudi Medical Journal
      Saudi Medical Journal

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          Abstract

          Objectives:

          To quantify the reduction in absence due to upper respiratory infections (URIs) among primary schoolgirls attending Riyadh’s schools after delivering a hand hygiene workshop intervention over a period of 5 weeks.

          Methods:

          A cluster randomized trial was conducted among girls attending 4 primary schools between January and March 2018. The participants attended a hand hygiene workshop. The schoolgirls’ absences were followed up for 5 weeks. Incidence rate, percentage of absence days, and absence rate were calculated for total and URIs absences.

          Result:

          Total number of participating schoolgirls was 496. Upper respiratory infections accounted for 15.3% of absence episodes. Schoolgirls lost 521 days of school and 19.4% of them were URIs-related. Absence rate due to URIs were 12.4 and 23.4 as well as 5.62 and 11.72 per 100 schoolgirls in the control (CG) and experimental (EG) groups, respectively. Percentage of absence days were lower in the experimental group (CG: 0.86% and 1.39% versus EG: 0.39% and 0.72%). Incidence rates of absence due to URIs were 0.54 and 1.02 in CG versus 0.24 and 0.51 in EG per 100 schoolgirls per day.

          Conclusion:

          There could be further reduction in school absences if education was accompanied by hand soap dissemination. The study could serve as a pilot for major studies in the future. Sustainability of the intervention can be tested in studies with longer durations.

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          Most cited references15

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          Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis.

          To quantify the effect of hand-hygiene interventions on rates of gastrointestinal and respiratory illnesses and to identify interventions that provide the greatest efficacy, we searched 4 electronic databases for hand-hygiene trials published from January 1960 through May 2007 and conducted meta-analyses to generate pooled rate ratios across interventions (N=30 studies). Improvements in hand hygiene resulted in reductions in gastrointestinal illness of 31% (95% confidence intervals [CI]=19%, 42%) and reductions in respiratory illness of 21% (95% CI=5%, 34%). The most beneficial intervention was hand-hygiene education with use of nonantibacterial soap. Use of antibacterial soap showed little added benefit compared with use of nonantibacterial soap. Hand hygiene is clearly effective against gastrointestinal and, to a lesser extent, respiratory infections. Studies examining hygiene practices during respiratory illness and interventions targeting aerosol transmission are needed.
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            Effects of Hand Hygiene Campaigns on Incidence of Laboratory-confirmed Influenza and Absenteeism in Schoolchildren, Cairo, Egypt

            To evaluate the effectiveness of an intensive hand hygiene campaign on reducing absenteeism caused by influenza-like illness (ILI), diarrhea, conjunctivitis, and laboratory-confirmed influenza, we conducted a randomized control trial in 60 elementary schools in Cairo, Egypt. Children in the intervention schools were required to wash hands twice each day, and health messages were provided through entertainment activities. Data were collected on student absenteeism and reasons for illness. School nurses collected nasal swabs from students with ILI, which were tested by using a qualitative diagnostic test for influenza A and B. Compared with results for the control group, in the intervention group, overall absences caused by ILI, diarrhea, conjunctivitis, and laboratory-confirmed influenza were reduced by 40%, 30%, 67%, and 50%, respectively (p<0.0001 for each illness). An intensive hand hygiene campaign was effective in reducing absenteeism caused by these illnesses.
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              Evaluating the Relationship Between Student Attendance and Achievement in Urban Elementary and Middle Schools: An Instrumental Variables Approach

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                Author and article information

                Journal
                Saudi Med J
                Saudi Med J
                Saudi Medical Journal
                Saudi Medical Journal (Saudi Arabia )
                0379-5284
                October 2018
                : 39
                : 10
                : 1044-1049
                Affiliations
                [1] From the Department of Family and Community Medicine (Alzaher); Faculty of Medicine, King Saud University, from the Prince Sattam Chair for Epidemiology and Public Health Research, Department of Family and Community Medicine (Gosadi), Faculty of Medicine, King Saud University; from the Field Epidemiology Training Program (Almudarra), Assistant Agency of Preventive Health, Public Health Agency, Ministry of Health; and from the Osteoporosis Control Program, Health Programs and Chronic Diseases Department (Mustafa), Public Health Directorate, Directorate General of Health Affairs, Riyadh, Kingdom of Saudi Arabia
                Author notes
                Address correspondence and reprint request to: Dr. Abrar Alzaher, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: abraralzaher@ 123456yahoo.com ORCID ID: orcid.org/0000-0003-3156-6675
                Article
                SaudiMedJ-39-1044
                10.15537/smj.2018.10.23344
                6201029
                30284589
                3987b3c4-2124-41d8-9643-14cc6a2d7d1f
                Copyright: © Saudi Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 July 2018
                : 19 September 2018
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