An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities

作者：Nicholson Julie A; Naeeni Mojgan; Hoptroff Michael; Matheson Jane R; Roberts Anthony J; Taylor David; Sidibe Myriam; Weir Anthony J; Damle Satyawan G; Wright Richard L^*

来源：Tropical Medicine and International Health, 2014, 19(3): 284-292.

DOI：10.1111/tmi.12254

• hand washing with soap
• diarrhoea
• acute respiratory infection
• hygiene
• school absence

Objectives To evaluate how an intervention, which combined hand washing promotion aimed at 5-year-olds with provision of free soap, affected illnesses among the children and their families and children's school absenteeism.
Methods We monitored illnesses, including diarrhoea and acute respiratory infections (ARIs), school absences and soap consumption for 41weeks in 70 low-income communities in Mumbai, India (35 communities per arm).
Results Outcomes from 847 intervention households (containing 847 5-year-olds and 4863 subjects in total) and 833 control households (containing 833 5-year-olds and 4812 subjects) were modelled using negative binomial regression. Intervention group 5-year-olds had fewer episodes of diarrhoea (-25%, 95% confidence intervals [CI]=-37%, -2%), ARIs (-15%, 95% CI=-30%, -8%), school absences due to illnesses (-27%, 95% CI=-41%, -18%) and eye infections (-46%, 95% CI=-58%, -31%). Further, there were fewer episodes of diarrhoea and ARIs in the intervention group for whole families' (-31%, 95% CI=-37%, -5%; and -14%, 95% CI=-23%, -6%, respectively), 6- to 15-year-olds (-30%, 95% CI=-39%, -7%; and -15%, 95% CI=-24%, -6%) and under 5s (-32%, 95% CI=-41%, -4%; and -20%, 95% CI=-29%, -8%).
Conclusions Direct-contact hand washing interventions aimed at younger school-aged children can affect the health of the whole family. These may be scalable through public-private partnerships and classroom-based campaigns. Further work is required to understand the conditions under which health benefits are transferred and the mechanisms for transference.

• 出版日期2014-3