Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial

Aiello, Allison E.; Pérez, Vanessa; Coulborn, Rebecca M.; Davis, Brian M.; Uddin, Monica; Monto, Arnold S.

doi:10.1371/journal.pone.0029744

Cited by 187 publications

(270 citation statements)

References 21 publications

(37 reference statements)

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“…Three newer cluster randomised trials with influenza and influenza-like illness as outcomes were not eligible for inclusion as they examined the effect of hand hygiene only in combination with facemask use. All three studies (two in university halls of residence in the USA 38,39 and one of secondary transmission in German households 40 ) suggested a reduction in influenza and ⁄ or ILI in groups receiving hand hygiene and facemasks compared with controls but results were generally not statistically significant. A recently published cluster randomised trial 41 of regular hand sanitiser use on ILI absence in Thai pre-schools was not eligible for inclusion because insufficient data were presented on ILI episodes to allow an effect measure to be calculated.…”

Section: Laboratory-con Irmed In Luenza Outcomesmentioning

confidence: 98%

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

Warren‐Gash

Fragaszy

Hayward

2012

Influenza Resp Viruses

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Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low-quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower-middle-income setting. There was high-quality evidence of a small reduction in respiratory infection in childcare settings. There was high-quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low-income setting. There was moderate-to highquality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance.

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Section: Laboratory-con Irmed In Luenza Outcomesmentioning

confidence: 98%

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

Warren‐Gash

Fragaszy

Hayward

2012

Influenza Resp Viruses

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“…96 97 Efficacy of facemasks in the community We identified nine RCTs of facemasks in various household and community settings, [11][12][13][14][15][16][17][18][19] and in all but one they were used for respiratory protection. In one household trial the use of facemasks was tested as source control to prevent the spread of infections from the wearer.…”

Section: Stat E O F T H E a Rt R Ev I E Wmentioning

confidence: 99%

“…The threat of pandemic A/H5N1 influenza and resultant pandemic planning drove the first RCTs of facemasks in various settings. [7][8][9][10][11][12][13][14][15][16][17][18][19] The aim of this review is to inform policy makers and stakeholders by examining and summarising the available evidence related to the efficacy of facemasks and respirators, current practice, and guidelines, as well as highlighting the gaps in evidence.…”

Section: Introductionmentioning

confidence: 99%

Facemasks for the prevention of infection in healthcare and community settings

MacIntyre

Chughtai

2015

BMJ

273

304

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Facemasks are recommended for diseases transmitted through droplets and respirators for respiratory aerosols, yet recommendations and terminology vary between guidelines. The concepts of droplet and airborne transmission that are entrenched in clinical practice have recently been shown to be more complex than previously thought. Several randomised clinical trials of facemasks have been conducted in community and healthcare settings, using widely varying interventions, including mixed interventions (such as masks and handwashing), and diverse outcomes. Of the nine trials of facemasks identified in community settings, in all but one, facemasks were used for respiratory protection of well people. They found that facemasks and facemasks plus hand hygiene may prevent infection in community settings, subject to early use and compliance. Two trials in healthcare workers favoured respirators for clinical respiratory illness. The use of reusable cloth masks is widespread globally, particularly in Asia, which is an important region for emerging infections, but there is no clinical research to inform their use and most policies offer no guidance on them. Health economic analyses of facemasks are scarce and the few published cost effectiveness models do not use clinical efficacy data. The lack of research on facemasks and respirators is reflected in varied and sometimes conflicting policies and guidelines. Further research should focus on examining the efficacy of facemasks against specific infectious threats such as influenza and tuberculosis, assessing the efficacy of cloth masks, investigating common practices such as reuse of masks, assessing compliance, filling in policy gaps, and obtaining cost effectiveness data using clinical efficacy estimates.

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“…As a result, mothers took excess preventive measures at home; e.g., mother did not want to take her child out (participant 7). Healthcare professionals should explain possible preventive methods to avoid reoccurrence, e.g., hand hygiene and/or facemasks; however, evidence for the effectiveness of any preventive methods is limited [35] [36]. Therefore, they should also explain that excess preventives are not needed because it is impossible for mothers to prevent ACIs entirely and most children will suffer from ACIs again.…”

Section: Discussionmentioning

confidence: 99%

Maternal Uncertainty about Infants’ Hospitalization for Acute Childhood Illness: A Qualitative Study

Ueki¹,

Takao²,

Komai³

et al. 2017

OJN

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Mothers often express intense stress and uncertainty when their children develop acute childhood illnesses and it is important for healthcare professionals to consider maternal uncertainty when providing support for mothers. This study aimed to examine maternal uncertainty about children's hospitalization due to acute childhood illnesses. We recruited 15 Japanese mothers of children aged 1 -12 months who had been hospitalized for the first time due to acute childhood illnesses, and conducted unstructured interviews with the participants at the time of discharge. Content analysis was used to examine uncertainty in their expression of their psychological state. Mothers' uncertainty was classified into five categories: ambiguity about the severity of the illness, unpredictability of the course of the illness, discrepancy of the judgement with healthcare professionals, lack of information about the causes of the illness, and ambiguous appropriateness of management. The former three categories were reported as uncertainty of mothers of children with chronic diseases, while the latter two categories were particularly characteristic of mothers of children with acute childhood illnesses. It is, therefore, important to explore the causes of children's illnesses and help mothers build confidence in their ability to manage their children's illness before discharge.

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Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial

Cited by 187 publications

References 21 publications

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

Facemasks for the prevention of infection in healthcare and community settings

Maternal Uncertainty about Infants’ Hospitalization for Acute Childhood Illness: A Qualitative Study

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