Hand sanitisers for reducing illness absences in primary school children in New Zealand: a cluster randomised controlled trial study protocol

Abstract

BackgroundNew Zealand has relatively high rates of morbidity and mortality from infectious disease compared with other OECD countries, with infectious disease being more prevalent in children compared with others in the population. Consequences of infectious disease in children may have significant economic and social impact beyond the direct effects of the disease on the health of the child; including absence from school, transmission of infectious disease to other pupils, staff, and family members, and time off work for parents/guardians. Reduction of the transmission of infectious disease between children at schools could be an effective way of reducing the community incidence of infectious disease. Alcohol based no-rinse hand sanitisers provide an alternative hand cleaning technology, for which there is some evidence that they may be effective in achieving this. However, very few studies have investigated the effectiveness of hand sanitisers, and importantly, the potential wider economic implications of this intervention have not been established.AimsThe primary objective of this trial is to establish if the provision of hand sanitisers in primary schools in the South Island of New Zealand, in addition to an education session on hand hygiene, reduces the incidence rate of absence episodes due to illness in children. In addition, the trial will establish the cost-effectiveness and conduct a cost-benefit analysis of the intervention in this setting.Methods/DesignA cluster randomised controlled trial will be undertaken to establish the effectiveness and cost-effectiveness of hand sanitisers. Sixty-eight primary schools will be recruited from three regions in the South Island of New Zealand. The schools will be randomised, within region, to receive hand sanitisers and an education session on hand hygiene, or an education session on hand hygiene alone. Fifty pupils from each school in years 1 to 6 (generally aged from 5 to 11 years) will be randomly selected for detailed follow-up about their illness absences, providing a total of 3400 pupils. In addition, absence information will be collected on all children from the school rolls. Investigators not involved in the running of the trial, outcome assessors, and the statistician will be blinded to the group allocation until the analysis is completed.Trial registrationACTRN12609000478213

Adequacy of handwashing facilities in public toilets in Dunedin, New Zealand

“…In Australia, an increasing proportion of the population is engaging in oral-genital sexual practices over time and at a younger age. 8 We recently analysed incidence trends of head and neck tumours in Australia between 1982 and 2005, stratified into those cancers established to be HPVassociated and those that are not, 9 according to the classification of Ryerson et al 10 We noted a decline in non HPV-associated cancers in males but a significant increase in HPV-associated cancers over time. This trend has also been noted internationally 10,11 and suggests that careful monitoring is required as to the relative contribution of population level risk factors for head and neck cancers into the future.…”

“…1 We obtained cancer data from the National Cancer Statistics Clearinghouse database, as previously described. 9,10 Relative survival proportions were calculated by the Cancer and Dunedin. All such toilets were included in the study.…”

“…9 This checklist was piloted in 10 toilets and minor adjustments were made to response options and formatting. We sought to assess toilets likely to be used by the general public, including public toilets maintained by the Dunedin City Council (DCC); toilets in other 'public' locations such as museums, art galleries, large shops, etc; and toilets in food premises.…”

Back to the Future: Rising to the Semmelweis Challenge in Hand Hygiene

“…There is also convincing evidence that hand hygiene, both hand washing [149,150] and hand rubbing [151][152][153][154][155][156][157], is effective against infectious respiratory viral syndromes and diarrheal diseases when introduced in a lay populations outside the healthcare setting.…”

Reasons for absenteeism in rural primary schools in two Colombian municipalities

“…El 55,1% de la población participante eran hombres y el 71,6% tenían entre 5 y 9 años. La tasa de ausentismo general fue 5,7 episodios por niño-año, IC 95% (5,5-5,8) y 8,6 días por niño-año, IC 95% (8,(4)(5)(6)(7)(8)9). Las principales razones del ausentismo fueron enfermedades (24,4%), chequeo médico u odontológico (12,9%), viajes (12,3%), falta de motivación para asistir a la escuela (10,0%) y mal clima (9,3%).…”