Reducing gastroenteritis occurrences and their consequences in elementary schools with alcohol-based hand sanitizers.
BACKGROUND
Schools are a source of epidemic seasonal dissemination-in particular gastroenteritis among children and the general population. We assessed the impact of an alcohol-based sanitizer on gastroenteritis and its subsequent consequences.


METHODS
A study was conducted in 2 primary schools over a 17-week period, before and throughout the seasonal gastroenteritis period. The intervention, under strict teacher supervision and in a realistic and long lasting manner, consisted of 1 school rubbing an alcohol-based sanitizer into the hands of the school children. The primary outcome was the proportion of children without any occurrence of gastroenteritis during the study period both in the treated group and the control group, which were 2 separate schools. A Cox proportional hazards model was used to assess the hazard ratio. Secondary outcomes were the number of gastroenteritis episodes, doctor appointments, absenteeism, and working days lost by a parent.


RESULTS
Four thousand six hundred fifty-four weekly questionnaires were collected. One hundred fifty-five children presented with at least 1 occurrence of gastroenteritis during the study period: 64 of 259 in the treatment group and 91 of 217 in the control group (χ2 = 16.4, P < 0.0001). The instantaneous risk of primary infection, at any time of the study, for children receiving the treatment was multiplied by 0.52 (95% CI: [0.37,0.71]) compared with children not receiving the treatment. The average number of gastroenteritis episodes was 0.31 in the treatment group and 0.53 in the control group (P < 0.001).


CONCLUSIONS
Systematic and controlled use of alcohol-based sanitizers during the epidemic season could significantly reduce the incidence of gastroenteritis in primary school children.
Service des maladies infectieuses, CHR Orléans La Source, Orleans, France. thierry.prazuck@chr-orleans.fr
Thierry
T
Prazuck
Géraldine
G
Compte-Nguyen
Camille
C
Pelat
Simon
S
Sunder
Thierry
T
Blanchon
D000279:Administration, Cutaneous; D000438:Alcohols / Q000008:administration & dosage* / Q000009:adverse effects; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000009:adverse effects; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012574:Schools / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D000438:Alcohols; D000891:Anti-Infective Agents, Local; D000998:Antiviral Agents