tetano
Editor, Senior Moderator
The Journal of Allergy and Clinical Immunology
PII: S0091-6749(12)01432-7
doi:10.1016/j.jaci.2012.08.031
Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?
Lynn B. Gerald, MSPH, PhDemail address
,
Joe K. Gerald, MD, PhD
,
Bin Zhang, PhD
,
Leslie A. McClure, PhD
,
William C. Bailey, MD
,
Kathy F. Harrington, MPH, PhD
Received 9 July 2012; received in revised form 16 August 2012; accepted 17 August 2012. published online 15 October 2012.
Corrected Proof
Abstract
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Background
Viral upper respiratory tract infections have been implicated as a major cause of asthma exacerbations among school-aged children. Regular hand washing is the most effective method to prevent the spread of viral respiratory tract infections, but effective hand-washing practices are difficult to establish in schools.
Objectives
This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools? usual hand hygiene practices.
Methods
This was a 2-year, community-based, randomized controlled crossover trial. Schools were randomized to usual care and then intervention (sequence 1) or intervention and then usual care (sequence 2). Intervention schools were provided with alcohol-based hand sanitizer, hand soap, and hand hygiene education. The primary outcome was the proportion of students experiencing an asthma exacerbation each month. Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school.
Results
Five hundred twenty-seven students with asthma were enrolled among 31 schools. The hand hygiene intervention did not reduce the number of asthma exacerbations compared with the schools? usual hand hygiene practices (P = .132). There was a strong temporal trend because both sequences experienced fewer exacerbations during year 2 compared with year 1 (P < .001).
Conclusions
Although the intervention was not found to be effective, the results were confounded by the H1N1 influenza pandemic that resulted in substantially increased hand hygiene behaviors and resources in usual-care schools. Therefore these results should be viewed cautiously.
http://www.jacionline.org/article/S0091-6749(12)01432-7/abstract
PII: S0091-6749(12)01432-7
doi:10.1016/j.jaci.2012.08.031
Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?
Lynn B. Gerald, MSPH, PhDemail address
,
Joe K. Gerald, MD, PhD
,
Bin Zhang, PhD
,
Leslie A. McClure, PhD
,
William C. Bailey, MD
,
Kathy F. Harrington, MPH, PhD
Received 9 July 2012; received in revised form 16 August 2012; accepted 17 August 2012. published online 15 October 2012.
Corrected Proof
Abstract
Full Text
Images
References
Background
Viral upper respiratory tract infections have been implicated as a major cause of asthma exacerbations among school-aged children. Regular hand washing is the most effective method to prevent the spread of viral respiratory tract infections, but effective hand-washing practices are difficult to establish in schools.
Objectives
This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools? usual hand hygiene practices.
Methods
This was a 2-year, community-based, randomized controlled crossover trial. Schools were randomized to usual care and then intervention (sequence 1) or intervention and then usual care (sequence 2). Intervention schools were provided with alcohol-based hand sanitizer, hand soap, and hand hygiene education. The primary outcome was the proportion of students experiencing an asthma exacerbation each month. Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school.
Results
Five hundred twenty-seven students with asthma were enrolled among 31 schools. The hand hygiene intervention did not reduce the number of asthma exacerbations compared with the schools? usual hand hygiene practices (P = .132). There was a strong temporal trend because both sequences experienced fewer exacerbations during year 2 compared with year 1 (P < .001).
Conclusions
Although the intervention was not found to be effective, the results were confounded by the H1N1 influenza pandemic that resulted in substantially increased hand hygiene behaviors and resources in usual-care schools. Therefore these results should be viewed cautiously.
http://www.jacionline.org/article/S0091-6749(12)01432-7/abstract