title: Appropriate time-interval application of alcohol hand gel on reducing influenza-like illness among preschool children: a randomized, controlled trial.
abstract: BACKGROUND
  We studied the efficacy of different time-interval applications of alcohol hand gel as a strategy for the prevention of influenza-like illness (ILI) in preschool-age children.
  
  
  METHODS
  We performed a classroom-based cluster randomization at a kindergarten school in Bangkok, Thailand. A total of 1437 children were placed into 3 test groups, based on the frequency of alcohol hand gel use for hand hygiene: only before lunch (q lunch), every 120 minutes (q 120), and every 60 minutes (q 60). The primary outcome was a change in the school absenteeism rate caused by ILI.
  
  
  RESULTS
  The rates of absenteeism from confirmed ILI (sick days/present days) were 0.026 in the q lunch group, 0.025 in the q 120 group, and 0.017 in the q 60 group. Significant reductions in absenteeism rates were seen when comparing the q 60 group with the q 120 group (rate difference, 0.009; 95% confidence interval [CI], -0.002 to 0.015; P = .008) and comparing the q 60 group with the q lunch group (rate difference, 0.0096; 95% CI, 0.004-0.016; P = .002). No such differences were detected between the q 120 and q lunch groups (rate difference, 0.001; 95% CI, 0.005-0.007; P = .743).
  
  
  CONCLUSIONS
  The compulsory hourly use of alcohol gel as classroom hand disinfection could significantly reduce the rate of absenteeism from ILI in preschool-age children.
authors.affiliation: Department of Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand. sidpd@mahidol.ac.th
authors.forename: Denla
authors.initials: D
authors.lastname: Pandejpong
authors.forename: Somwang
authors.initials: S
authors.lastname: Danchaivijitr
authors.forename: Nirun
authors.initials: N
authors.lastname: Vanprapa
authors.forename: Temyos
authors.initials: T
authors.lastname: Pandejpong
authors.forename: Earl Francis
authors.initials: EF
authors.lastname: Cook
mesh_terms: D000041:Absenteeism; D000438:Alcohols / Q000008:administration & dosage*; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D004202:Disinfectants / Q000008:administration & dosage*; D005260:Female; D005782:Gels / Q000008:administration & dosage; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D013785:Thailand; D013997:Time Factors
chemical_list: D000438:Alcohols; D004202:Disinfectants; D005782:Gels