Trial reportThe Pediatric infectious disease journal2011
Reduction in the incidence of influenza A but not influenza B associated with use of hand sanitizer and cough hygiene in schools: a randomized controlled trial.
Trial report in The Pediatric infectious disease journal, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 11 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Physical interventions to interrupt or reduce the spread of respiratory viruses.The Cochrane database of systematic reviews · 2023Pooled it
- The effectiveness of hand hygiene interventions for preventing community transmission or acquisition of novel coronavirus or influenza infections: a systematic review.BMC public health · 2022Pooled it
- Impact of educational interventions on the prevention of influenza: A systematic review.Frontiers in public health · 2022Pooled it
- The effect of hand hygiene promotion programs during epidemics and pandemics of respiratory droplet-transmissible infections on health outcomes: a rapid systematic review.BMC public health · 2021Pooled it
- Pooled it
- Physical interventions to interrupt or reduce the spread of respiratory viruses.The Cochrane database of systematic reviews · 2020Pooled it
- Hand Sanitizers: A Review on Formulation Aspects, Adverse Effects, and Regulations.International journal of environmental research and public health · 2020Pooled it
- Rinse-free hand wash for reducing absenteeism among preschool and school children.The Cochrane database of systematic reviews · 2020Pooled it
- Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: a systematic review and meta-analysis.Archives of disease in childhood · 2016Pooled it
- Hand hygiene and risk of influenza virus infections in the community: a systematic review and meta-analysis.Epidemiology and infection · 2014Pooled it
- Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review.Influenza and other respiratory viruses · 2013Pooled it
- Effectiveness of a Behavior Change Intervention with Hand Sanitizer Use and Respiratory Hygiene in Reducing Laboratory-Confirmed Influenza among Schoolchildren in Bangladesh: A Cluster Randomized Controlled Trial.The American journal of tropical medicine and hygiene · 2019Trial
- Hand sanitiser provision for reducing illness absences in primary school children: a cluster randomised trial.PLoS medicine · 2014Trial
- Aerosol transmission is an important mode of influenza A virus spread.Nature communications · 2013Trial
- Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?The Journal of allergy and clinical immunology · 2012Trial
- Nasal microbiome and phageome profiles are associated with prospective respiratory viral infection risk in school-age children.The Journal of allergy and clinical immunology · 2026Article
- Ventilation does not affect close-range transmission of influenza virus in a ferret playpen setup.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Kukaa Salama (Staying Safe): a pre-post trial of an interactive informational mobile health intervention for increasing COVID-19 prevention practices with urban refugee youth in Uganda.International health · 2024Article
- Comparative Pathology of Animal Models for Influenza A Virus Infection.Pathogens (Basel, Switzerland) · 2023Review
- A review of facilities management interventions to mitigate respiratory infections in existing buildings.Building and environment · 2022Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundLaboratory-based evidence is lacking regarding the efficacy of nonpharmaceutical interventions (NPIs) such as alcohol-based hand sanitizer and respiratory hygiene to reduce the spread of influenza.
methodsThe Pittsburgh Influenza Prevention Project was a cluster-randomized trial conducted in 10 elementary schools in Pittsburgh, PA, during the 2007 to 2008 influenza season. Children in 5 intervention schools received training in hand and respiratory hygiene, and were provided and encouraged to use hand sanitizer regularly. Children in 5 schools acted as controls. Children with influenza-like illness were tested for influenza A and B by reverse-transcriptase polymerase chain reaction.
resultsA total of 3360 children participated in this study. Using reverse-transcriptase polymerase chain reaction, 54 cases of influenza A and 50 cases of influenza B were detected. We found no significant effect of the intervention on the primary study outcome of all laboratory-confirmed influenza cases (incidence rate ratio [IRR]: 0.81; 95% confidence interval [CI]: 0.54, 1.23). However, we did find statistically significant differences in protocol-specified ancillary outcomes. Children in intervention schools had significantly fewer laboratory-confirmed influenza A infections than children in control schools, with an adjusted IRR of 0.48 (95% CI: 0.26, 0.87). Total absent episodes were also significantly lower among the intervention group than among the control group; adjusted IRR 0.74 (95% CI: 0.56, 0.97).
conclusionsNPIs (respiratory hygiene education and the regular use of hand sanitizer) did not reduce total laboratory-confirmed influenza. However, the interventions did reduce school total absence episodes by 26% and laboratory-confirmed influenza A infections by 52%. Our results suggest that NPIs can be an important adjunct to influenza vaccination programs to reduce the number of influenza A infections among children.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.