Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt

Abstract

To evaluate the effectiveness of an intensive hand hygiene campaign on reducing absenteeism caused by influenza-like illness (ILI), diarrhea, conjunctivitis, and laboratory-confirmed influenza, we conducted a randomized control trial in 60 elementary schools in Cairo, Egypt. Children in the intervention schools were required to wash hands twice each day, and health messages were provided through entertainment activities. Data were collected on student absenteeism and reasons for illness. School nurses collected nasal swabs from students with ILI, which were tested by using a qualitative diagnostic test for influenza A and B. Compared with results for the control group, in the intervention group, overall absences caused by ILI, diarrhea, conjunctivitis, and laboratory-confirmed influenza were reduced by 40%, 30%, 67%, and 50%, respectively (p<0.0001 for each illness). An intensive hand hygiene campaign was effective in reducing absenteeism caused by these illnesses.

Figure 1

Episodes of absence because of influenza-like illness, diarrhea, and conjunctivitis in the intervention and control schools, by weeks, Cairo, Egypt, February–May 2008. Error bars indicate SEM.

Figure 2

Diagram of results of influenza testing for students with influenza-like illness (ILI) in intervention and control schools, Cairo, Egypt, February–May 2008. Testing was done with QuickVue Rapid Antigen Test (Quidel Corp., San Diego, CA, USA).

Figure 3

Episodes of laboratory-confirmed influenza A and B in the intervention and control schools, by weeks, Cairo, Egypt, February–May 2008. Error bars indicate SEM.