title: Effectiveness of non-pharmaceutical measures in preventing pediatric influenza: a case-control study.
abstract: BACKGROUND
  Hygiene behavior plays a relevant role in infectious disease transmission. The aim of this study was to evaluate non-pharmaceutical interventions (NPI) in preventing pediatric influenza infections.
  
  
  METHODS
  Laboratory confirmed influenza cases occurred during 2009-10 and 2010-11 seasons matched by age and date of consultation. NPI (frequency of hand washing, alcohol-based hand sanitizer use and hand washing after touching contaminated surfaces) during seven days prior to onset of symptoms were obtained from parents of cases and controls.
  
  
  RESULTS
  Cases presented higher prevalence of underlying conditions such as pneumonia [OR = 3.23; 95% CI: 1.38-7.58 p = 0.007], asthma [OR = 2.45; 95% CI: 1.17-5.14 p = 0.02] and having more than 1 risk factor [OR = 1.67; 95% CI: 0.99-2.82 p = 0.05]. Hand washing more than 5 times per day [aOR = 0.62; 95% CI: 0.39-0.99 p = 0.04] was the only statistically significant protective factor. When considering two age groups (pre-school age 0-4 yrs and school age 5-17) yrs , only the school age group showed a negative association for influenza infection for both washing more than 5 times per day [aOR = 0.47; 95% CI: 0.22-0.99 p = 0.04] and hand washing after touching contaminated surfaces [aOR = 0.19; 95% CI: 0.04-0.86 p = 0.03].
  
  
  CONCLUSIONS
  Frequent hand washing should be recommended to prevent influenza infection in the community setting and in special in the school age group.
authors.affiliation: Public Health Agency of Catalonia, Cr Roc Boronat 81-95, 08005, Barcelona, Spain. nuria.torner@gencat.cat.|CIBER Epidemiología y Salud Pública, (CIBERESP), Cr de Casanova, 143, 08036, Barcelona, Spain. nuria.torner@gencat.cat.|Public Health Department, Faculty of Pharmacy, University of Barcelona, Cr Roc Boronat 81-95, 08005, Barcelona, Spain. nuria.torner@gencat.cat.
authors.forename: Núria
authors.initials: N
authors.lastname: Torner
authors.affiliation: Public Health Department, Faculty of Pharmacy, University of Barcelona, Cr Roc Boronat 81-95, 08005, Barcelona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Soldevila
authors.affiliation: Pediatric Unit, Hospital Sant Joan de Déu, Cr Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain.
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Garcia
authors.affiliation: Pediatric Unit, Hospital Sant Joan de Déu, Cr Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain.
authors.forename: Cristian
authors.initials: C
authors.lastname: Launes
authors.affiliation: Public Health Agency of Catalonia, Cr Roc Boronat 81-95, 08005, Barcelona, Spain.|CIBER Epidemiología y Salud Pública, (CIBERESP), Cr de Casanova, 143, 08036, Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Godoy
authors.affiliation: CIBER Epidemiología y Salud Pública, (CIBERESP), Cr de Casanova, 143, 08036, Barcelona, Spain.|Instituto de Salud Pública de Navarra, C/Leyre,15, 31002, Pamplona, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Castilla
authors.affiliation: CIBER Epidemiología y Salud Pública, (CIBERESP), Cr de Casanova, 143, 08036, Barcelona, Spain.|Public Health Department, Faculty of Pharmacy, University of Barcelona, Cr Roc Boronat 81-95, 08005, Barcelona, Spain.
authors.forename: Angela
authors.initials: A
authors.lastname: Domínguez
mesh_terms: D000293:Adolescent; D001249:Asthma; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006235:Hand Disinfection; D006293:Health Promotion; D006801:Humans; D006920:Hygiene; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D012307:Risk Factors; D012574:Schools; D013030:Spain