Article type
Year
Abstract
Background:Hand hygiene is one of the most effective ways to prevent the spread of disease. In health education, people are advised to wash their hands frequently. But there is a lack of recommendations on the frequency of handwashing, and the current research conclusions about the frequency of handwashing and disease prevention effects are not uniform.
Objectives:To explore the relationship between hand washing times and disease prevention effects by a systematic review and meta-analysis.
Methods:PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang and China Biology Medicine disc will be searched without search date and language restriction using “handwashing”, “hand hygiene”, “prevent*”, “frequency” and “times” etc. The Review Manager version 5.3. software was used to meta intervention effect. Subgroup analysis will be undertaken on study design. Also, Egger's test will be performed to evaluate the publication bias of the included studies. We assessed the quality of evidence with respect to each outcome indicator using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Results:A total of 8 studies were included. Meta-analysis results showed that there was no statistical significance in the effect of disease prevention on whether handwashing was more than 4 times/day (OR=0.61, 95%CI 0.37 to 1.01). The results of a case-control study showed that compared with handwashing ≤4 times/day, handwashing 5-10 times/day and handwashing > 10 times/day could prevent disease infection, and the results were respectively OR=0.75 (95%CI 0.63 to 0.91) and OR=0.65 (95%CI 0.53 to 0.80). There was no statistical significance between handwashing 10 times/day and 5 to 10 times/day (OR=0.86, 95%CI 0.70 to 1.06). Compared with handwashing ≤10 times/day, handwashing > 10 times/day was a protective factor against infection (OR=0.59, 95%CI 0.36 to 0.97). Patients assigned to the intensive hand-washing intervention group washed their hands more frequently compared with the control group (seven vs four times a day) and developed fewer episodes of diarrheal illness (WMD=-1.68, 95%CI -1.93 to -1.43). All the above the quality of evidence was low.
Conclusions:The higher the frequency of handwashing, the better the effect of disease prevention, but so far there is no high-quality evidence indicating the best range of handwashing times for disease prevention. In the future, large-scale trials will be required to explore. It is necessary for health workers to increase publicity on hand hygiene education, which is a low-cost and high-efficiency health measure.
Patient or healthcare consumer involvement: None.
Objectives:To explore the relationship between hand washing times and disease prevention effects by a systematic review and meta-analysis.
Methods:PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang and China Biology Medicine disc will be searched without search date and language restriction using “handwashing”, “hand hygiene”, “prevent*”, “frequency” and “times” etc. The Review Manager version 5.3. software was used to meta intervention effect. Subgroup analysis will be undertaken on study design. Also, Egger's test will be performed to evaluate the publication bias of the included studies. We assessed the quality of evidence with respect to each outcome indicator using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Results:A total of 8 studies were included. Meta-analysis results showed that there was no statistical significance in the effect of disease prevention on whether handwashing was more than 4 times/day (OR=0.61, 95%CI 0.37 to 1.01). The results of a case-control study showed that compared with handwashing ≤4 times/day, handwashing 5-10 times/day and handwashing > 10 times/day could prevent disease infection, and the results were respectively OR=0.75 (95%CI 0.63 to 0.91) and OR=0.65 (95%CI 0.53 to 0.80). There was no statistical significance between handwashing 10 times/day and 5 to 10 times/day (OR=0.86, 95%CI 0.70 to 1.06). Compared with handwashing ≤10 times/day, handwashing > 10 times/day was a protective factor against infection (OR=0.59, 95%CI 0.36 to 0.97). Patients assigned to the intensive hand-washing intervention group washed their hands more frequently compared with the control group (seven vs four times a day) and developed fewer episodes of diarrheal illness (WMD=-1.68, 95%CI -1.93 to -1.43). All the above the quality of evidence was low.
Conclusions:The higher the frequency of handwashing, the better the effect of disease prevention, but so far there is no high-quality evidence indicating the best range of handwashing times for disease prevention. In the future, large-scale trials will be required to explore. It is necessary for health workers to increase publicity on hand hygiene education, which is a low-cost and high-efficiency health measure.
Patient or healthcare consumer involvement: None.