Evidence for hand hygiene promotion during outbreaks of respiratory infections


Today is Global Handwashing Day, the ideal moment to highlight our most recent publication “The effect of hand hygiene promotion programs during epidemics and pandemics of respiratory droplet-transmissible infections on health outcomes: a rapid systematic review”. The quickly evolving nature of the COVID-19 pandemic has put pressure on formulating evidence-based recommendations. To quickly identify the best available evidence, CEBaP has developed a “rapid systematic review” to search for studies on the effectiveness of community-based hand hygiene promotion programs on the transmission of respiratory infections during an epidemic or pandemic.

Since the review was conducted early on in the pandemic (April-May 2020), limited evidence from controlled studies was available for COVID-19, and therefore studies of similar infections, such as influenza, were also included. Twelve studies were identified, which were conducted in households, schools and the occupational setting. Hand hygiene promotion was achieved via a training or via the dissemination of leaflets, posters or videos. All studies were conducted during an influenza epidemic or interepidemic period. No studies on COVID-19 were identified, although we found an interesting protocol for a randomized controlled trial that will measure the effect of the promotion of proper COVID-19 hand hygiene practices. In our current review we could conclude that preventive hand hygiene promotion interventions in interepidemic periods significantly decreased influenza positive cases in the school setting. However, no improvement could be demonstrated when hand washing promotion is being implemented in households to prevent secondary influenza transmission from already infected household members (epidemic and interepidemic periods). Main message for hand washing promotion: the earlier, the better!