School toilets: facilitating hand hygiene? A review of primary school hygiene facilities in a developed country

Reeves, Lesley; Priest, Patricia; Poore, Marion R

doi:10.1093/pubmed/fds028

Cited by 14 publications

(13 citation statements)

References 10 publications

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“…Third, research should include process evaluation to refine interventions and establish intervention acceptability and fidelity. Studies which have done process evaluations 40 57 have identified barriers to hand hygiene including access to adequate sanitary facilities (even in high-income countries), suggesting that provision of hygiene products and education may be insufficient to achieve effective infection prevention and control and more robust studies of complex, multicomponent interventions are required. Fourth, studies should evaluate cost, cost-effectiveness and intervention sustainability in educational settings.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: a systematic review and meta-analysis

et al. 2015

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ObjectiveTo undertake a systematic review and meta-analysis to establish the effectiveness of handwashing in reducing absence and/or the spread of respiratory tract (RT) and/or gastrointestinal (GI) infection among school-aged children and/or staff in educational settings.DesignRandomised-controlled trials (RCTs).SettingSchools and other settings with a formal educational component in any country.PatientsChildren aged 3–11 years, and/or staff working with them.InterventionInterventions with a hand hygiene component.Main outcome measuresIncidence of RT or GI infections or symptoms related to such infections; absenteeism; laboratory results of RT and/or GI infections.ResultsEighteen cluster RCTs were identified; 13 school-based, 5 in child day care facilities or preschools. Studies were heterogeneous and had significant quality issues including small numbers of clusters and participants and inadequate randomisation. Individual study results suggest interventions may reduce children's absence, RT infection incidence and symptoms, and laboratory confirmed influenza-like illness. Evidence of impact on GI infection or symptoms was equivocal.ConclusionsStudies are generally not well executed or reported. Despite updating existing systematic reviews and identifying new studies, evidence of the effect of hand hygiene interventions on infection incidence in educational settings is mostly equivocal but they may decrease RT infection among children. These results update and add to knowledge about this crucial public health issue in key settings with a vulnerable population. More robust, well reported cluster RCTs which learn from existing studies, are required.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: a systematic review and meta-analysis

et al. 2015

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“…As such, it is critical to understand the current knowledge, attitude and behaviour of good hygiene and its impact on the increased diarrhoea illness in a residential community of a developed country. In addition, most of the current understanding of the knowledge, attitude and behaviour on hygiene was significantly focused on less developed communities [20][21][22][23][24], and very limited in the well-developed communities [11,25]. Therefore, we aim to determine the current knowledge, attitude and behaviour of good hygiene as well as risk factors of diarrhoea disease in a developed community in Singapore, where clean water and soap are easily available and affordable.…”

Section: Introductionmentioning

confidence: 99%

Current knowledge, attitude and behaviour of hand and food hygiene in a developed residential community of Singapore: a cross-sectional survey

2015

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BackgroundDiarrhoea incidence has been increasing progressively over the past years in developed countries, including Singapore, despite the accessibility and availability to clean water, well-established sanitation infrastructures and regular hygiene promotion. The aim of this study is to determine the current knowledge, attitude and behaviour of hand and food hygiene, and the potential risk factors of diarrhoea in a residential community of Singapore.MethodsA cross-sectional study was conducted within a residential area in the west of Singapore from June to August 2013. A total of 1,156 household units were randomly sampled and invited to participate in an interviewer-assisted survey using standardised questionnaires. Descriptive, univariate and multivariate analyses were performed using descriptive statistics, Fisher’s Exact test and multivariate logistic regression modelling, respectively. R program was used for all statistical analysis. All tests were conducted at 5 % level of significance with 95 % confidence intervals (CI) reported where applicable.ResultsA total of 240 units (20.8 %) consented and responded to the survey invitation. About 77 % of the expected knowledge and attitude were observed in at least 80 % of the participants, compared to only about 31 % of the expected behaviours and practises. Being single [adjusted odds ratio (AOR) = 2.29; 95 % CI = 1.16-4.48], having flu in the past six month (AOR = 3.24; 95 % CI = 1.74-6.06), preferred self-medication (AOR = 2.07; 95 % CI = 1.06–4.12) were risk factors of diarrhoea. Washing hands with water before attending to children or sick persons (AOR = 0.30; 95 % CI = 0.11–0.82), washing hands with water (AOR = 0.16; 95 % CI = 0.05–0.45) and water with soap (AOR = 0.29; 95 % CI = 0.12–0.72) after attending to children or sick persons, and hand washing between 30 s to a minute (AOR = 0.44; 95 % CI = 0.20-0.90) were protective factors against diarrhoea.ConclusionsGood knowledge and attitude of the participants did not positively translate into high compliance and motivation to perform good hygiene practices. This observation may have resulted in a significant extent on the increasing diarrhoea incidences. Current interventions may be improved with more active community partnership among the residents, schools and the relevant social organizations, to raise awareness on the importance of compliance to good hygiene practices, and the risk factors of diarrhoea. A large case–control study would be required to validate these findings in future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1910-3) contains supplementary material, which is available to authorized users.

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“…We aimed to test whether the addition of hand sanitiser in primary school classrooms compared with usual hand hygiene (use of soap and water, mainly in school bathrooms) would reduce illness absences in primary school children in New Zealand. We chose to use hand sanitiser as our hand hygiene modality in preference to increasing use of existing facilities because school bathroom hand-washing facilities are of variable quality [16] , [17] , which might be a barrier to attempts to increase hand-washing. Improving and maintaining bathroom facilities in a large number of schools would be a major undertaking, and hand sanitiser is an acceptable alternative to hand-washing with soap and water for children [18] .…”

Section: Introductionmentioning

confidence: 99%

Hand Sanitiser Provision for Reducing Illness Absences in Primary School Children: A Cluster Randomised Trial

et al. 2014

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School toilets: facilitating hand hygiene? A review of primary school hygiene facilities in a developed country

Abstract: These results suggest that a significant number of New Zealand children do not currently have access to high quality hygiene facilities at school.

Cited by 14 publications

References 10 publications

Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: a systematic review and meta-analysis

Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: a systematic review and meta-analysis

Current knowledge, attitude and behaviour of hand and food hygiene in a developed residential community of Singapore: a cross-sectional survey

Hand Sanitiser Provision for Reducing Illness Absences in Primary School Children: A Cluster Randomised Trial

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