Effectiveness of hand hygiene in an epidemic context. Systematic review

Abstract

Objective: To assess the effectiveness of Hand Hygiene (HH) in preventing infections and the transmission of pathogens, in an epidemic context, in community and hospital settings.
Method: It is a systematic review of the literature based on a document request, conducted on PubMed, using the following search equation: "(" Hand Hygiene "[All Fields] OR" Hand Disinfection "[All Fields]) AND ("Epidemics" [All Fields] OR "Pandemics" [All Fields]) ". All publications related to the effectiveness of the preventive intervention for HH in an epidemic setting were Included.
Results: A total of 16 publications were included, of which the majority proved the effectiveness of HH and its promotion in reducing infections during an epidemic. In a clinical trial, promoting HH in an intervention group significantly reduced the prevalence of infections (24.4% vs. 11.1%). Two systematic reviews have shown the effectiveness of HH in preventing the transmission of germs with ORs between 0.52 and 0.62. Four case-control studies and three cross-sectional studies concluded with the protective effect of HH with ORs varying between 0.06 and 0.71. A cohort study showed that low adherence to HH recommendations was associated with a higher infection rate (77.5% vs 95%; p = 0.02). A single systematic review did not conclude that HH was effective in the epidemic setting.
Conclusion: The effectiveness of HH in the fight against epidemics has been demonstrated. It is dependent on the engagement and the active participation of the different intervenient. Hence the need to increase accessibility to different methods of HH and to promote the importance of this prevention strategy could be assured through education and awareness.