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      How Frequently Do We Touch Facial T-Zone: A Systematic Review

      review-article
      1 , 2 , 3
      Annals of Global Health
      Ubiquity Press

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          Abstract

          Background:

          Researchers across the world are emphasising the importance of hand-washing and limited touching of face to curb the spread of COVID-19. However, access to safe water and hygiene is inadequate in many places around the globe; hence T-zone touching restriction is considered more worthwhile compared to other prevention strategies.

          Aim:

          A systematic review was carried out to appraise the frequency of T-zone (eyes, nose, mouth, chin) touching in humans to comprehend the challenge of its restriction, and thus support public health professionals to produce evidence synthesis guidance for public.

          For this systemic review, data were collected by keyword searching, and several online databases were searched. The PRISMA checklist, PECO protocol and STROBE guideline were followed in this review, and pooled data were analysed in R version 4.

          Result:

          Total of 10 single arms observational studies were included. The pooled average (SD) facial self-touch per hour was 50.06 (±47) times, and a specific touch of T-zone was 68.7 (±27). T-zone self-touch within the total facial self-touch was found higher R = 0.680, with 95% CI 0.14, 0.91, P = 0.02 and X 2 = 167.63, P < 0.0001.

          Conclusion:

          The review found that face-touch is a type of consistent regulatory movements. Control of T-zone touch requires extensive behaviour intervention and community awareness.

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          Most cited references18

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          A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19)

          Coronavirus disease 2019 (COVID-19) is a declared global pandemic. There are multiple parameters of the clinical course and management of the COVID-19 that need optimization. A hindrance to this development is the vast amount of misinformation present due to scarcely sourced manuscript preprints and social media. This literature review aims to presents accredited and the most current studies pertaining to the basic sciences of SARS-CoV-2, clinical presentation and disease course of COVID-19, public health interventions, and current epidemiological developments. The review on basic sciences aims to clarify the jargon in virology, describe the virion structure of SARS-CoV-2 and present pertinent details relevant to clinical practice. Another component discussed is the brief history on the series of experiments used to explore the origins and evolution of the phylogeny of the viral genome of SARS-CoV-2. Additionally, the clinical and epidemiological differences between COVID-19 and other infections causing outbreaks (SARS, MERS, H1N1) are elucidated. Emphasis is placed on evidence-based medicine to evaluate the frequency of presentation of various symptoms to create a stratification system of the most important epidemiological risk factors for COVID-19. These can be used to triage and expedite risk assessment. Furthermore, the limitations and statistical strength of the diagnostic tools currently in clinical practice are evaluated. Criteria on rapid screening, discharge from hospital and discontinuation of self-quarantine are clarified. Epidemiological factors influencing the rapid rate of spread of the SARS-CoV-2 virus are described. Accurate information pertinent to improving prevention strategies is also discussed. The penultimate portion of the review aims to explain the involvement of micronutrients such as vitamin C and vitamin D in COVID19 treatment and prophylaxis. Furthermore, the biochemistry of the major candidates for novel therapies is briefly reviewed and a summary of their current status in the clinical trials is presented. Lastly, the current scientific data and status of governing bodies such as the Center of Disease Control (CDC) and the WHO on the usage of controversial therapies such as angiotensin-converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs) (Ibuprofen), and corticosteroids usage in COVID-19 are discussed. The composite collection of accredited studies on each of these subtopics of COVID-19 within this review will enable clarification and focus on the current status and direction in the planning of the management of this global pandemic.
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            A Study Quantifying the Hand-to-Face Contact Rate and Its Potential Application to Predicting Respiratory Tract Infection

            A substantial portion of human respiratory tract infection is thought to be transmitted via contaminated hand contact with the mouth, eyes, and/or nostrils. Thus, a key risk factor for infection transmission should be the rate of hand contact with these areas termed target facial membranes. A study was conducted in which 10 subjects were each videotaped for 3 hr while performing office-type work in isolation from other persons. The number of contacts to the eyes, nostrils, and lips was scored during subsequent viewing of the tapes. The total contacts per subject had sample mean x = 47 and sample standard deviation s = 34. The average total contact rate per hour was 15.7. The authors developed a relatively simple algebraic model for estimating the dose of pathogens transferred to target facial membranes during a defined exposure period. The model considers the rate of pathogen transfer to the hands via contact with contaminated environmental surfaces, and the rate of pathogen loss from the hands due to pathogen die-off and transfer from the hands to environmental surfaces and to target facial membranes during touching. The estimation of infection risk due to this dose also is discussed. A hypothetical but plausible example involving influenza A virus transmission is presented to illustrate the model.
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              Transmission of rhinovirus colds by self-inoculation.

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                Author and article information

                Contributors
                Journal
                Ann Glob Health
                Ann Glob Health
                2214-9996
                Annals of Global Health
                Ubiquity Press
                2214-9996
                06 July 2020
                2020
                : 86
                : 1
                : 75
                Affiliations
                [1 ]School of Population Health, The University of Auckland, Auckland, NZ
                [2 ]International Organization for Migration (IOM), United Nations Migration Agency, BD
                [3 ]The University of Auckland, Auckland, NZ
                Author notes
                Corresponding author: Juma Rahman ( j.rahman@ 123456auckland.ac.nz )
                Article
                10.5334/aogh.2956
                7350942
                32704480
                477f9549-f5ea-4889-9aa6-9c004fa89ee9
                Copyright: © 2020 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

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