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Article: Findings from a household randomized controlled trial of hand washing and face masks to reduce influenza transmission in Bangkok, Thailand

TitleFindings from a household randomized controlled trial of hand washing and face masks to reduce influenza transmission in Bangkok, Thailand
Authors
Issue Date2011
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/subs.asp?ref=1750-2640&site=1
Citation
Influenza And Other Respiratory Viruses, 2011, v. 5 n. 4, p. 256-267 How to Cite?
AbstractBackground Evidence is needed on the effectiveness of non-pharmaceutical interventions (NPIs) to reduce influenza transmission. Methodology We studied NPIs in households with a febrile, influenza-positive child. Households were randomized to control, hand washing (HW), or hand washing plus paper surgical face masks (HW+FM) arms. Study nurses conducted home visits within 24hours of enrollment and on days 3, 7, and 21. Respiratory swabs and serum were collected from all household members and tested for influenza by RT-PCR or serology. Principal Findings Between April 2008 and August 2009, 991 (16·5%) of 5995 pediatric influenza-like illness patients tested influenza positive. Four hundred and forty-two index children with 1147 household members were enrolled, and 221 (50·0%) were aged <6years. Three hundred and ninety-seven (89·8%) households reported that the index patient slept in the parents' bedroom. The secondary attack rate was 21·5%, and 56/345 (16·3%; 95% CI 12·4-20·2%) secondary cases were asymptomatic. Hand-washing subjects reported 4·7 washing episodes/day, compared to 4·9 times/day in the HW+FM arm and 3·9 times/day in controls (P=0·001). The odds ratios (ORs) for secondary influenza infection were not significantly different in the HW arm (OR=1·20; 95% CI 0·76-1·88; P-0.442), or the HW+FM arm (OR=1·16; 95% CI.0·74-1·82; P=0.525). Conclusions Influenza transmission was not reduced by interventions to promote hand washing and face mask use. This may be attributable to transmission that occurred before the intervention, poor facemask compliance, little difference in hand-washing frequency between study groups, and shared sleeping arrangements. A prospective study design and a careful analysis of sociocultural factors could improve future NPI studies. © 2011 Blackwell Publishing Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/135663
ISSN
2015 Impact Factor: 2.378
2015 SCImago Journal Rankings: 1.570
ISI Accession Number ID
Funding AgencyGrant Number
MedImmune Inc.
Funding Information:

BJC has received research funding from MedImmune Inc. The opinions, assertions, findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the Department of the Army or the Department of Defense.

References

 

DC FieldValueLanguage
dc.contributor.authorSimmerman, JMen_HK
dc.contributor.authorSuntarattiwong, Pen_HK
dc.contributor.authorLevy, Jen_HK
dc.contributor.authorJarman, RGen_HK
dc.contributor.authorKaewchana, Sen_HK
dc.contributor.authorGibbons, RVen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorSanasuttipun, Wen_HK
dc.contributor.authorMaloney, SAen_HK
dc.contributor.authorUyeki, TMen_HK
dc.contributor.authorKamimoto, Len_HK
dc.contributor.authorChotipitayasunondh, Ten_HK
dc.date.accessioned2011-07-27T01:38:58Z-
dc.date.available2011-07-27T01:38:58Z-
dc.date.issued2011en_HK
dc.identifier.citationInfluenza And Other Respiratory Viruses, 2011, v. 5 n. 4, p. 256-267en_HK
dc.identifier.issn1750-2640en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135663-
dc.description.abstractBackground Evidence is needed on the effectiveness of non-pharmaceutical interventions (NPIs) to reduce influenza transmission. Methodology We studied NPIs in households with a febrile, influenza-positive child. Households were randomized to control, hand washing (HW), or hand washing plus paper surgical face masks (HW+FM) arms. Study nurses conducted home visits within 24hours of enrollment and on days 3, 7, and 21. Respiratory swabs and serum were collected from all household members and tested for influenza by RT-PCR or serology. Principal Findings Between April 2008 and August 2009, 991 (16·5%) of 5995 pediatric influenza-like illness patients tested influenza positive. Four hundred and forty-two index children with 1147 household members were enrolled, and 221 (50·0%) were aged <6years. Three hundred and ninety-seven (89·8%) households reported that the index patient slept in the parents' bedroom. The secondary attack rate was 21·5%, and 56/345 (16·3%; 95% CI 12·4-20·2%) secondary cases were asymptomatic. Hand-washing subjects reported 4·7 washing episodes/day, compared to 4·9 times/day in the HW+FM arm and 3·9 times/day in controls (P=0·001). The odds ratios (ORs) for secondary influenza infection were not significantly different in the HW arm (OR=1·20; 95% CI 0·76-1·88; P-0.442), or the HW+FM arm (OR=1·16; 95% CI.0·74-1·82; P=0.525). Conclusions Influenza transmission was not reduced by interventions to promote hand washing and face mask use. This may be attributable to transmission that occurred before the intervention, poor facemask compliance, little difference in hand-washing frequency between study groups, and shared sleeping arrangements. A prospective study design and a careful analysis of sociocultural factors could improve future NPI studies. © 2011 Blackwell Publishing Ltd.en_HK
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/subs.asp?ref=1750-2640&site=1en_HK
dc.relation.ispartofInfluenza and other Respiratory Virusesen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAntibodies, Viral - blooden_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshDisease Transmission, Infectious - prevention & controlen_HK
dc.subject.meshEnzyme-Linked Immunosorbent Assayen_HK
dc.subject.meshFamily Characteristicsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHandwashing - methodsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfanten_HK
dc.subject.meshInfant, Newbornen_HK
dc.subject.meshInfluenza, Human - prevention & controlen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMasks - utilizationen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNasopharynx - virologyen_HK
dc.subject.meshOrthomyxoviridae - isolation & purificationen_HK
dc.subject.meshRNA, Viral - genetics - isolation & purificationen_HK
dc.subject.meshReverse Transcriptase Polymerase Chain Reactionen_HK
dc.subject.meshSerum - virologyen_HK
dc.subject.meshThailanden_HK
dc.subject.meshYoung Adulten_HK
dc.titleFindings from a household randomized controlled trial of hand washing and face masks to reduce influenza transmission in Bangkok, Thailanden_HK
dc.typeArticleen_HK
dc.identifier.emailCowling, BJ:bcowling@hku.hken_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1750-2659.2011.00205.xen_HK
dc.identifier.pmid21651736-
dc.identifier.scopuseid_2-s2.0-79958743676en_HK
dc.identifier.hkuros187482en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79958743676&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume5en_HK
dc.identifier.issue4en_HK
dc.identifier.spage256en_HK
dc.identifier.epage267en_HK
dc.identifier.isiWOS:000292497700007-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridSimmerman, JM=6602325311en_HK
dc.identifier.scopusauthoridSuntarattiwong, P=26641614100en_HK
dc.identifier.scopusauthoridLevy, J=35262135600en_HK
dc.identifier.scopusauthoridJarman, RG=16052947100en_HK
dc.identifier.scopusauthoridKaewchana, S=6504566192en_HK
dc.identifier.scopusauthoridGibbons, RV=7202916860en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridSanasuttipun, W=26664968500en_HK
dc.identifier.scopusauthoridMaloney, SA=7005810852en_HK
dc.identifier.scopusauthoridUyeki, TM=6603544967en_HK
dc.identifier.scopusauthoridKamimoto, L=11739580000en_HK
dc.identifier.scopusauthoridChotipitayasunondh, T=52563465200en_HK
dc.identifier.citeulike9333078-

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