Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?
Identifieur interne : 001486 ( Ncbi/Curation ); précédent : 001485; suivant : 001487Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?
Auteurs : Lynn B. Gerald ; Joe K. Gerald ; Bin Zhang ; Leslie A. Mcclure ; William C. Bailey ; Kathy F. HarringtonSource :
- The Journal of allergy and clinical immunology [ 0091-6749 ] ; 2012.
Descripteurs français
- KwdFr :
- Alcools (administration et posologie), Asthme (immunologie), Désinfection des mains (), Enfant, Femelle, Grippe humaine (), Humains, Hygiène des mains (), Mâle, Recherche participative basée sur la communauté, Services de santé scolaire, Sous-type H1N1 du virus de la grippe A, Études croisées, Évolution de la maladie.
- MESH :
- administration et posologie : Alcools.
- immunologie : Asthme.
- Désinfection des mains, Enfant, Femelle, Grippe humaine, Humains, Hygiène des mains, Mâle, Recherche participative basée sur la communauté, Services de santé scolaire, Sous-type H1N1 du virus de la grippe A, Études croisées, Évolution de la maladie.
English descriptors
- KwdEn :
- Alcohols (administration & dosage), Asthma (immunology), Child, Community-Based Participatory Research, Cross-Over Studies, Disease Progression, Female, Hand Disinfection (methods), Hand Hygiene (methods), Humans, Influenza A Virus, H1N1 Subtype, Influenza, Human (prevention & control), Male, School Health Services.
- MESH :
- chemical , administration & dosage : Alcohols.
- immunology : Asthma.
- methods : Hand Disinfection, Hand Hygiene.
- prevention & control : Influenza, Human.
- Child, Community-Based Participatory Research, Cross-Over Studies, Disease Progression, Female, Humans, Influenza A Virus, H1N1 Subtype, Male, School Health Services.
Abstract
Viral upper respiratory infections have been implicated as a major cause of asthma exacerbations among school age children. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections but, effective hand washing practices are difficult to establish in schools.
This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools’ usual hand hygiene practices.
This was a two year, community-based, randomized controlled crossover trial. Schools were randomized to usual care then intervention (Sequence 1) or intervention then usual care (Sequence 2). Intervention schools were provided with alcohol-based hand sanitizer, hand soap, and hand hygiene education. The primary outcome was the proportion of students experiencing an asthma exacerbation each month. Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school.
527 students with asthma were enrolled among 31 schools. The hand hygiene intervention did not reduce the number of asthma exacerbations as compared to the schools’ usual hand hygiene practices (p=0.132). There was a strong temporal trend as both sequences experienced fewer exacerbations during Year 2 as compared to Year 1 (p<0.001).
While the intervention was not found to be effective, the results were confounded by the H1N1 influenza pandemic that resulted in substantially increased hand hygiene behaviors and resources in usual care schools. Therefore, these results should be viewed cautiously.
Url:
DOI: 10.1016/j.jaci.2012.08.031
PubMed: 23069487
PubMed Central: 3511646
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PMC:3511646Le document en format XML
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<author><name sortKey="Zhang, Bin" sort="Zhang, Bin" uniqKey="Zhang B" first="Bin" last="Zhang">Bin Zhang</name>
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<author><name sortKey="Mcclure, Leslie A" sort="Mcclure, Leslie A" uniqKey="Mcclure L" first="Leslie A." last="Mcclure">Leslie A. Mcclure</name>
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<term>Asthma (immunology)</term>
<term>Child</term>
<term>Community-Based Participatory Research</term>
<term>Cross-Over Studies</term>
<term>Disease Progression</term>
<term>Female</term>
<term>Hand Disinfection (methods)</term>
<term>Hand Hygiene (methods)</term>
<term>Humans</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Influenza, Human (prevention & control)</term>
<term>Male</term>
<term>School Health Services</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Alcools (administration et posologie)</term>
<term>Asthme (immunologie)</term>
<term>Désinfection des mains ()</term>
<term>Enfant</term>
<term>Femelle</term>
<term>Grippe humaine ()</term>
<term>Humains</term>
<term>Hygiène des mains ()</term>
<term>Mâle</term>
<term>Recherche participative basée sur la communauté</term>
<term>Services de santé scolaire</term>
<term>Sous-type H1N1 du virus de la grippe A</term>
<term>Études croisées</term>
<term>Évolution de la maladie</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Alcohols</term>
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<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Alcools</term>
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<keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Asthme</term>
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<keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Asthma</term>
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<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Hand Disinfection</term>
<term>Hand Hygiene</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Child</term>
<term>Community-Based Participatory Research</term>
<term>Cross-Over Studies</term>
<term>Disease Progression</term>
<term>Female</term>
<term>Humans</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Male</term>
<term>School Health Services</term>
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<term>Enfant</term>
<term>Femelle</term>
<term>Grippe humaine</term>
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<term>Hygiène des mains</term>
<term>Mâle</term>
<term>Recherche participative basée sur la communauté</term>
<term>Services de santé scolaire</term>
<term>Sous-type H1N1 du virus de la grippe A</term>
<term>Études croisées</term>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P2">Viral upper respiratory infections have been implicated as a major cause of asthma exacerbations among school age children. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections but, effective hand washing practices are difficult to establish in schools.</p>
</sec>
<sec id="S2"><title>Objectives</title>
<p id="P3">This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools’ usual hand hygiene practices.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P4">This was a two year, community-based, randomized controlled crossover trial. Schools were randomized to usual care then intervention (Sequence 1) or intervention then usual care (Sequence 2). Intervention schools were provided with alcohol-based hand sanitizer, hand soap, and hand hygiene education. The primary outcome was the proportion of students experiencing an asthma exacerbation each month. Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P5">527 students with asthma were enrolled among 31 schools. The hand hygiene intervention did not reduce the number of asthma exacerbations as compared to the schools’ usual hand hygiene practices (p=0.132). There was a strong temporal trend as both sequences experienced fewer exacerbations during Year 2 as compared to Year 1 (p<0.001).</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P6">While the intervention was not found to be effective, the results were confounded by the H1N1 influenza pandemic that resulted in substantially increased hand hygiene behaviors and resources in usual care schools. Therefore, these results should be viewed cautiously.</p>
</sec>
</div>
</front>
</TEI>
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