Xiaona Liu1, Wanli Hou2, Zhiguang Zhao2, Jinquan Cheng3, Ed F van Beeck4, Xiaodong Peng2, Kylah Jones5, Xia Fu2, Yan Zhou2, Zhen Zhang2, Jan Hendrik Richardus4, Vicki Erasmus4. 1. Shenzhen Center for Disease Control and Prevention, Longyuan Road No.8, Nanshan District, Shenzhen 518055, China; Erasmus MC, University Medical Centre Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. Electronic address: x.liu@erasmusmc.nl. 2. Shenzhen Center for Disease Control and Prevention, Longyuan Road No.8, Nanshan District, Shenzhen 518055, China. 3. Shenzhen Center for Disease Control and Prevention, Longyuan Road No.8, Nanshan District, Shenzhen 518055, China. Electronic address: cjinquan@szcdc.net. 4. Erasmus MC, University Medical Centre Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. 5. Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: To evaluate the effect of the "Clean Hands, Happy Life" intervention on the incidence of hand, food and mouth disease (HFMD) and on school absences due to sickness in kindergarten students. METHODS: The intervention consisted of four hand hygiene (HH) promotion components and was evaluated in a cluster-randomized controlled trial among 8275 children and 18 kindergartens from May to October, 2015 in Shenzhen, China. We compared two intervention arms - received the intervention in kindergartens only and in both kindergartens and families, respectively - to the control arm in multilevel analyses. RESULTS: During the follow-up, the incidence of HFMD in both intervention arms was significantly lower than in the control arm (IRR1: 0.39, 95%CI: 0.26-0.59; IRR2: 0.30, 95%CI: 0.19-0.49); the duration of absence due to sickness (in days) in both intervention arms was significantly shorter than in the control arm (β1 = 0.58, 95%CI: 0.41-0.74; β2 = 0.34, 95%CI: 0.17-0.50), controlling for the area type of kindergarten and grade level of children. Furthermore, during the follow-up we found that there were fewer episodes of absence due to respiratory, skin and eye infections (P < 0.05). CONCLUSIONS: Our intervention is effective at reducing HFMD infections and absence due to sickness in children attending kindergartens in China.
RCT Entities:
OBJECTIVES: To evaluate the effect of the "Clean Hands, Happy Life" intervention on the incidence of hand, food and mouth disease (HFMD) and on school absences due to sickness in kindergarten students. METHODS: The intervention consisted of four hand hygiene (HH) promotion components and was evaluated in a cluster-randomized controlled trial among 8275 children and 18 kindergartens from May to October, 2015 in Shenzhen, China. We compared two intervention arms - received the intervention in kindergartens only and in both kindergartens and families, respectively - to the control arm in multilevel analyses. RESULTS: During the follow-up, the incidence of HFMD in both intervention arms was significantly lower than in the control arm (IRR1: 0.39, 95%CI: 0.26-0.59; IRR2: 0.30, 95%CI: 0.19-0.49); the duration of absence due to sickness (in days) in both intervention arms was significantly shorter than in the control arm (β1 = 0.58, 95%CI: 0.41-0.74; β2 = 0.34, 95%CI: 0.17-0.50), controlling for the area type of kindergarten and grade level of children. Furthermore, during the follow-up we found that there were fewer episodes of absence due to respiratory, skin and eye infections (P < 0.05). CONCLUSIONS: Our intervention is effective at reducing HFMD infections and absence due to sickness in children attending kindergartens in China.
Authors: Xiaona Liu; Zhiguang Zhao; Wanli Hou; Suzanne Polinder; Ed F van Beeck; Zhen Zhang; Yan Zhou; Gang Liu; Xu Xie; Jinquan Cheng; Jan Hendrik Richardus; Vicki Erasmus Journal: PLoS One Date: 2019-05-14 Impact factor: 3.240