The Association of Hand Hygiene Practice on Primary Schoolgirls Absence Due to URIs in Riyadh City, 2017-2018.
Condition: Upper Respiratory Tract Infections
MeSH terms: Infections; Respiratory Tract Infections
Study type: Interventional

Summary: 
      Research Problem:

      Upper respiratory infections (URIs) are a common reason for absence from schools as it is
      estimated that children get six to eight episodes every year. In Jazan (2013-2014), 34% of
      primary health care centre attendees who were complaining of URIs were under 15 years old and
      42% of them were positive when tested for viruses by nasopharyngeal swabs. An intervention
      for URIs prevention is hand hygiene, as it has been shown to have an impact on reducing the
      risk of respiratory infections by 50% among children in Karachi, Pakistan by encouraging hand
      washing with soap. Another randomised controlled trial study conducted in Spain among primary
      school students showed a statistically significant 38% reduction in the absenteeism rate due
      to URIs in the intervention group who received education about hand hygiene and used hand
      sanitisers which were distributed among schools. Also, the Chinese conducted a cluster
      randomised control trial evaluating the effect of a hand washing programme and revealed a 38%
      reduction in absence due to URIs among primary schoolchildren.

      This preventive measure is questionable, as a randomised controlled trial done among primary
      school students in New Zealand revealed that encouraging the use of hand sanitisers in
      schools did not have an impact on reducing acute respiratory infections or absenteeism. The
      questionable effect was also documented in a systematic review and meta-analysis for
      randomised controlled trials about the effectiveness of hand hygiene in decreasing absences
      through illness in educational settings.

      Research Significance:

      Appropriate hand hygiene is recommended as a non-pharmacological preventive measure against
      respiratory infections. But this preventive measure is questionable as the results of
      randomised controlled trials about the effectiveness of different hand hygiene interventions
      in reducing absence due to upper respiratory tract infection in different educational
      settings are controversial. Furthermore, previous studies of hand hygiene interventions were
      low in quality and it is recommended to improve future studies relating to it. Also, there is
      no research on the effectiveness of these measures in Saudi Arabia. So, this piece will add
      new knowledge to local and international literature. In addition, this study may help the
      school health administration to develop a hand hygiene programme.

      Objectives:

        -  To determine if hand hygiene education is associated with school absence rates due to
           URIs reduction among primary schoolgirls in Riyadh city, 2017-2018

        -  To measure post-intervention total primary schoolgirl's absence rate (both groups) in
           Riyadh city, 2017-2018.

        -  To measure post-intervention primary schoolgirls' absence rate due to upper respiratory
           infections (both groups) in Riyadh city, 2017-2018.

      Methodology:

      Cluster RCT will be conducted among primary schoolgirls attending public schools in Riyadh
      city in the first education semester. Sampling will be multistage to end up with four
      schools. 616 schoolgirls who are attending the selected classes will be invited to the study.
      Two schools will be randomly assigned to the intervention, which includes one-hour hand
      washing workshop at the beginning of the study, in addition to posters. Parents will
      self-administer the questionnaire at baseline, in addition to a follow-up phone interview
      questionnaire.
    


Intervention name(s): Hand Hygiene Workshop
Intervention type(s): Other
Intervention description(s): Workshops included video-clip and interactive lecture about common infections in schools, methods of transmission, and hand washing procedure and time. Puzzle games related to hand hygiene were distributed among schoolgirls. Posters with cartoon princess picture promote for hand hygiene were also distributed among the schools.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: HAND HYGIENE, HAND WASHING, INFLUENZA, SCHOOL ABSENCE, SCHOOL CHILDREN, UPPER RESPIRATORY INFECTIONS