title: A hand hygiene intervention to reduce infections in child daycare: a randomized controlled trial.
abstract: Infections are common in children attending daycare centres (DCCs). We evaluated the effect of a hand hygiene (HH) intervention for caregivers on the incidence of gastrointestinal and respiratory infections in children. The intervention was evaluated in a two-arm cluster randomized controlled trial. Thirty-six DCCs received the intervention including HH products, training sessions, and posters/stickers. Thirty-five control DCCs continued usual practice. Incidence of episodes of diarrhoea and the common cold in children was monitored by parents during 6 months. Using multilevel Poisson regression, incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were obtained. Diarrhoeal incidence was monitored in 545 children for 91 937 days. During follow-up, the incidence was 3·0 episodes per child-year in intervention DCCs vs. 3·4 in control DCCs (IRR 0·90, 95% CI 0·73-1·11). Incidence of the common cold was monitored in 541 children for 91 373 days. During follow-up, the incidence was 8·2 episodes per child-year in intervention DCCs vs. 7·4 in control DCCs (IRR 1·07, 95% CI 0·97-1·19). In this study, no evidence for an effect of the intervention was demonstrated on the incidence of episodes of diarrhoea and the common cold.
authors.affiliation: Department of Infectious Disease Control,Municipal Public Health Service Rotterdam-Rijnmond,Rotterdam,The Netherlands.
authors.forename: T P
authors.initials: TP
authors.lastname: Zomer
authors.affiliation: Department of Public Health,Erasmus MC,University Medical Centre Rotterdam,Rotterdam,The Netherlands.
authors.forename: V
authors.initials: V
authors.lastname: Erasmus
authors.affiliation: Department of Public Health,Erasmus MC,University Medical Centre Rotterdam,Rotterdam,The Netherlands.
authors.forename: C W
authors.initials: CW
authors.lastname: Looman
authors.affiliation: Department of Infectious Disease Control,Municipal Public Health Service Rotterdam-Rijnmond,Rotterdam,The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Tjon-A-Tsien
authors.affiliation: Department of Public Health,Erasmus MC,University Medical Centre Rotterdam,Rotterdam,The Netherlands.
authors.forename: E F
authors.initials: EF
authors.lastname: Van Beeck
authors.affiliation: Department of Public Health,Erasmus MC,University Medical Centre Rotterdam,Rotterdam,The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: De Graaf
authors.affiliation: Department of Public Health,Erasmus MC,University Medical Centre Rotterdam,Rotterdam,The Netherlands.
authors.forename: A H E
authors.initials: AH
authors.lastname: Van Beeck
authors.affiliation: Department of Infectious Disease Control,Municipal Public Health Service Rotterdam-Rijnmond,Rotterdam,The Netherlands.
authors.forename: J H
authors.initials: JH
authors.lastname: Richardus
authors.affiliation: Department of Infectious Disease Control,Municipal Public Health Service Rotterdam-Rijnmond,Rotterdam,The Netherlands.
authors.forename: H A C M
authors.initials: HA
authors.lastname: Voeten
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D003139:Common Cold / Q000453:epidemiology / Q000517:prevention & control*; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D063373:Hand Hygiene; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male
keywords: Cold (common); gastroenteritis; hand hygiene; hygiene – professional; infectious disease control