Evidence map›Paper›PMID 26471110›Full record

SynthesisArchives of disease in childhood2016

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

Micky Willmott, Alexandra Nicholson, Heide Busse, Georgina J MacArthur, Sara Brookes, Rona Campbell

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Archives of disease in childhood, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07659340 (Effectiveness of Immersive and Embodied Enhancement Via "Virtual Reality" on the Sustainability of Hand Hygiene Compliance), which is not on this map. Cited by 69 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 6 pooled it
13.3field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT07659340 narecruitingnot on this mapstarted 2026, after this paper: background citation

Effectiveness of Immersive and Embodied Enhancement Via "Virtual Reality" on the Sustainability of Hand Hygiene Compliance: School-based RCT With 10-month Follow-up

TypeinterventionalSponsorThe University of Hong KongRan2026 to 2027Enrolled500ConditionsHand, Hygiene Practices and KnowledgeArmsVR Handwashing Game (2 sessions), VR Handwashing Game (1 session) + Video on hand hygiene (1 session)
3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 6 syntheses or guidelines pooled it, 146 citations in OpenAlex.

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  9. Effects of classroom cleaning on student health: a longitudinal study.Journal of exposure science & environmental epidemiology · 2022
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Micky WillmottSchool of Social and Community Medicine, University of Bristol, Bristol, UK.ORCID http://orcid.org/0000-0003-4656-4760
Alexandra NicholsonSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Heide BusseSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Georgina J MacArthurSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Sara BrookesSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Rona CampbellSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
University of Bristol · GB

Funding

Department of Health PB-PG-1207-15212Department of Health PDF-2013-06-026Medical Research Council MR/K023233/1Medical Research Council MR/KO232331/1Wellcome Trust
6 · The paper itself

Abstract

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. PATIENTS: Children 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.

Indexed as

AbsenteeismChildCommunicable Disease ControlCommunicable DiseasesGastrointestinal DiseasesHand DisinfectionHand HygieneHumansRandomized Controlled Trials as TopicRespiratory Tract InfectionsSchoolsInfectious DiseasesRespiratorySchool Health

Identifiers

PMID26471110
PMCPMC4717429
OpenAlexW2177153842

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.