Evidence map›Paper›PMID 41360478›Full record

SynthesisBMJ global health2025

Adherence to handwashing behaviour and its impact on the incidence and death of viral respiratory infectious diseases: a systematic review, meta-analysis and modelling study.

Wenkai Zhou, Can Chen, Jiaxing Qi, Mengsha Chen, Zhenglin Yuan, Jiani Miao, Jiaxin Chen, Daixi Jiang, Mengya Yang, Yuxia Du and 6 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

16 authors.

Wenkai Zhou *Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Can Chen *Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Jiaxing Qi *Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Mengsha Chen *Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Zhenglin YuanJohns Hopkins University, Baltimore, Maryland, USA.
Jiani MiaoDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Jiaxin ChenDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Daixi JiangDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Mengya YangDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Yuxia DuDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Kexin CaoDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Xiaoyue WuDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Yue YouDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Dingmo ChenDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Rongrong QuDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China.
Shigui YangDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China, Zhejiang University, Hangzhou, Zhejiang, China yangshigui@zju.edu.cn.ORCID 0000-0002-0147-297X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWashing hands is considered an effective way for preventing viral respiratory infections. This study systematically investigated the global and regional adherence to hand-washing behaviour and its impact on the incidence and death of viral respiratory infectious diseases (VRIDs).

methodsIn our systematic review and meta-analysis, we searched PubMed, Embase, Web of Science and Scopus for related studies. We included observational studies with raw data of adherence to handwashing (rates of acceptability of handwashing, daily habitual handwashing and key-moment handwashing) during VRID pandemics/epidemics. Pooled rates and effect of handwashing were calculated by random-effects model and generalised linear model.

resultsWe analysed 108 articles, generating 227 datasets. During VRID epidemics/pandemics, the global pooled rate of daily handwashing was 72.23% (95% CI 66.95% to 76.95%). The lowest rate was observed in Africa (pooled rate 59.46%, 95% CI 50.73% to 67.68%) and among public transportation workers (18.15%, 95% CI 6.54% to 41.26%). Global pooled rate of key moment handwashing was 65.11% (95% CI 59.74% to 70.28%), with the lowest rate being after handshaking (36.40%, 95% CI 18.49% to 56.52%) and among the elderly (22.86%, 95% CI 16.77% to 29.58%) and was higher during the COVID-19 pandemic than the 2009 H1N1 pandemic (72.02% vs 31.33%). The pooled rate of global acceptability of handwashing was 90.01% (95% CI 83.73% to 94.05%). Key-moment handwashing was associated with a reduction in COVID-19 incidence (β=-151.1, p=0.010), COVID-19 mortality (β=-0.066, p<0.001) and other COVID-19 related deaths (β=-0.112, p<0.001).

conclusionDuring the VRID epidemics/pandemics, the handwashing behaviour adherence was relatively low. Health education efforts targeting public transportation workers and the elderly should be intensified. Augmented key-moment handwashing adherence potentially led to a significant reduction of the incidence and death of VRIDs. PROSPERO REGISTRATION NUMBER: CRD42024499090.

Indexed as

COVID-19Guideline AdherenceHand DisinfectionRespiratory Tract InfectionsVirus DiseasesGlobal HealthHumansIncidencePandemicsSARS-CoV-2COVID-19Health policyHygiene

Identifiers

PMID41360478
PMCPMC12684194

What OpenQuestion holds

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Registered trials

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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.