Cited by 125Influenza Virus Research StudiesInfection Control in HealthcarePediatric health and respiratory diseases

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

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Warren‐Gash, Charlotte, Fragaszy, Ellen, Hayward, Andrew C.·2013·Influenza and Other Respiratory Viruses

Abstract

Please cite this paper as: Warren‐Gash et al. (2012) Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12015. 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 high‐quality 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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  1. [1]Global Influenza Programme. Pandemic Influenza Preparedness and Response: A WHO Guidance Document. Switzerland: World Health Organization, 2009; 71. 23741778
  2. [9]Higgins J, Deeks J, Altman D. Special topics in statistics: cluster randomized trials; in Higgins J, Green S (eds): Cochrane Handbook for Systematic Reviews of Interventions. Chichester: The Cochrane Collaboration, Wiley‐Blackwell, 2008; 493– 498.
  3. [43]Pandemic Influenza Preparedness Team. Respiratory and Hand Hygiene in an Influenza Pandemic: Scientific Evidence Base Review. London: Department of Health, 2011; 39.

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Authors
Warren‐Gash, C., Fragaszy, E., & Hayward, A. C.
Affiliations
The Royal Free Hospital (GB)
Corresponding author
Warren‐Gash, Charlotte
Venue
Influenza and Other Respiratory Viruses
Publisher
Wiley
Published
2012-10-08
Volume
7
Issue
5
Pages
738-749
ISSN
  • 1750-2640 (ISSN-L)
  • 1750-2659
OpenAlex
W1572873130
Cited by
125
References
48
Citations by year
2026: 1 · 2025: 10 · 2024: 9 · 2023: 11 · 2022: 18 · 2021: 23 · 2020: 12 · 2019: 7 · 2018: 8 · 2017: 1 · 2016: 6 · 2015: 10 · 2014: 6 · 2013: 2
FWCI
0.70
Type
journal article
Language
en
Open access
Locations
  • Influenza and Other Respiratory Viruses (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • Wellcome Trust
  • Medical Research Council (MR/K006584/1)
Topics
  • Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
Keywords
hand hygiene, influenza transmission, acute respiratory infections, community transmission, secondary transmission, schools, childcare settings, informal settlements, household transmission, low-income settings, infection prevention interventions
MeSH terms
Humans, Influenza, Human, Patient Compliance, Respiratory Tract Infections, Global Health, Hand Hygiene

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