Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review
Identifieur interne : 003198 ( Main/Exploration ); précédent : 003197; suivant : 003199Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review
Auteurs : Tom Jefferson [Italie, Australie] ; Ruth Foxlee [Australie] ; Chris Del Mar [Australie] ; Liz Dooley [Australie] ; Eliana Ferroni [Italie, Australie] ; Bill Hewak [Australie] ; Adi Prabhala [Australie] ; Sree Nair [Inde, Australie] ; Alex Rivetti [Italie, Australie]Source :
- BMJ [ 0959-8138 ] ; 2008-01-12.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- prevention & control : Respiratory Tract Infections, Virus Diseases.
- Teeft :
- Antiseptic hand, Benzalkonium chloride, Bond university, Cash incentives, Cheap interventions, Cluster coefficients, Cluster randomised, Cochrane, Cochrane database syst, Cohort, Cohort studies, Comparisons outcomes risk, Confidence interval, Confidence intervals, Control hospitals, Cost interventions, Data extraction, Demicheli, Denominator, Differential diagnosis, Disease control, Entry ports, Experimental rhinovirus infection, Firm conclusions, Frequent handwashing, Full papers, Gloves, Protective, Gojo industries, Hand Disinfection, Hand sanitiser, Handwashing, Handwashing programme, Health measures, Health sciences, Healthcare, Healthcare workers, Healthy adults, Healthy children, Heterogeneity, Humans, Hygiene, Hygienic measures, Inadequate items, Incidence rate, Incremental effect, Infection, Influenza, Influenza pandemic, Influenza vaccines, Lancet jefferson, Mask, Masks, Neuraminidase inhibitors, Normal care, Normal handwashing, Observational studies, Odds ratio, Odds ratios, Older children, Online, Overall effect, Pandemic, Patient days, Personal hygiene, Personal protection, Physical measures, Placebo, Placebo tissues, Poor descriptions, Potential confounders, Probable cases, Programme, Proper evaluation, Protective Clothing, Public health measures, Pyroglutamic acid, Quarantine, Randomisation, Randomisation process, Randomised, Relative risk, Relevant studies, Research table, Respiratory, Respiratory disease, Respiratory infection, Respiratory infections, Respiratory secretions, Respiratory syncytial virus, Respiratory syncytical virus, Respiratory syncytical virus infection, Respiratory virus infections, Respiratory viruses, Rivetti, Salicylic acid, Sars, Sars epidemic, School closure, Search strategy, Selection bias, Several studies, Skin cleanser, Standard practice, Study design, Study designs, Syncytial, Syncytical, Systematic review, Total events, Vaccine, Viral, Viral illness, Viral load, Virucidal, Virucidal tissues, Virus, Wash hands, Year olds, Younger children.
Abstract
Objective To systematically review evidence for the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. Data extraction Search strategy of the Cochrane Library, Medline, OldMedline, Embase, and CINAHL, without language restriction, for any intervention to prevent transmission of respiratory viruses (isolation, quarantine, social distancing, barriers, personal protection, and hygiene). Study designs were randomised trials, cohort studies, case-control studies, and controlled before and after studies. Data synthesis Of 2300 titles scanned 138 full papers were retrieved, including 49 papers of 51 studies. Study quality was poor for the three randomised controlled trials and most of the cluster randomised controlled trials; the observational studies were of mixed quality. Heterogeneity precluded meta-analysis of most data except that from six case-control studies. The highest quality cluster randomised trials suggest that the spread of respiratory viruses into the community can be prevented by intervening with hygienic measures aimed at younger children. Meta-analysis of six case-control studies suggests that physical measures are highly effective in preventing the spread of SARS: handwashing more than 10 times daily (odds ratio 0.45, 95% confidence interval 0.36 to 0.57; number needed to treat=4, 95% confidence interval 3.65 to 5.52); wearing masks (0.32, 0.25 to 0.40; NNT=6, 4.54 to 8.03); wearing N95 masks (0.09, 0.03 to 0.30; NNT=3, 2.37 to 4.06); wearing gloves (0.43, 0.29 to 0.65; NNT=5, 4.15 to 15.41); wearing gowns (0.23, 0.14 to 0.37; NNT=5, 3.37 to 7.12); and handwashing, masks, gloves, and gowns combined (0.09, 0.02 to 0.35; NNT=3, 2.66 to 4.97). The incremental effect of adding virucidals or antiseptics to normal handwashing to decrease the spread of respiratory disease remains uncertain. The lack of proper evaluation of global measures such as screening at entry ports and social distancing prevent firm conclusions being drawn. Conclusion Routine long term implementation of some physical measures to interrupt or reduce the spread of respiratory viruses might be difficult but many simple and low cost interventions could be useful in reducing the spread.
Url:
- https://api.istex.fr/ark:/67375/NVC-RX8R9H6Z-G/fulltext.pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190272
DOI: 10.1136/bmj.39393.510347.BE
Affiliations:
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<front><div type="abstract">Objective To systematically review evidence for the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. Data extraction Search strategy of the Cochrane Library, Medline, OldMedline, Embase, and CINAHL, without language restriction, for any intervention to prevent transmission of respiratory viruses (isolation, quarantine, social distancing, barriers, personal protection, and hygiene). Study designs were randomised trials, cohort studies, case-control studies, and controlled before and after studies. Data synthesis Of 2300 titles scanned 138 full papers were retrieved, including 49 papers of 51 studies. Study quality was poor for the three randomised controlled trials and most of the cluster randomised controlled trials; the observational studies were of mixed quality. Heterogeneity precluded meta-analysis of most data except that from six case-control studies. The highest quality cluster randomised trials suggest that the spread of respiratory viruses into the community can be prevented by intervening with hygienic measures aimed at younger children. Meta-analysis of six case-control studies suggests that physical measures are highly effective in preventing the spread of SARS: handwashing more than 10 times daily (odds ratio 0.45, 95% confidence interval 0.36 to 0.57; number needed to treat=4, 95% confidence interval 3.65 to 5.52); wearing masks (0.32, 0.25 to 0.40; NNT=6, 4.54 to 8.03); wearing N95 masks (0.09, 0.03 to 0.30; NNT=3, 2.37 to 4.06); wearing gloves (0.43, 0.29 to 0.65; NNT=5, 4.15 to 15.41); wearing gowns (0.23, 0.14 to 0.37; NNT=5, 3.37 to 7.12); and handwashing, masks, gloves, and gowns combined (0.09, 0.02 to 0.35; NNT=3, 2.66 to 4.97). The incremental effect of adding virucidals or antiseptics to normal handwashing to decrease the spread of respiratory disease remains uncertain. The lack of proper evaluation of global measures such as screening at entry ports and social distancing prevent firm conclusions being drawn. Conclusion Routine long term implementation of some physical measures to interrupt or reduce the spread of respiratory viruses might be difficult but many simple and low cost interventions could be useful in reducing the spread.</div>
</front>
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