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网络干预正确洗手可有效预防呼吸道感染

2015-08-13 MedSci MedSci原创

2minute medicine



1.在这个开放、随机试验中,通过网络教育和鼓励参与者进行正确洗手,16周后发现参与者呼吸道感染及流感样发作较对照组减少。

2.实验组较对照组呼吸道感染发生率下降的同时,胃肠道感染发病率也下降。

呼吸道感染(RTIs)一般可以通过空气传播和接触传播,手就是接触传播的重要媒介。目前公认,洗手是组织细菌传播的重要方法,在H1N1流感大流行时尤其重要。然而并没有随机试验能提供足够的证据证明洗手的在防止呼吸道感染中的具体价值。本实验拟通过网络干预研究洗手是否可以降低成年人及其家庭成员呼吸道感染的发病率。本实验根据是否网络干预及是否进行初始调查问卷将参与者随机分为四组。16周后随访了解呼吸道感染或者流感样发作的发生情况及持续时间。

大约20000名试验对象参与了这项研究,近85%的参与者完成了16周的随访。研究表明网络干预组51%人群发生呼吸道感染少于对照组的59%。流感样发作人群实验组也较对照组少。由于样本量较大采用的是自我报告的方式可能会有人为偏差,这是本实验的局限性。

《柳叶刀》杂志相关的研究如下

题目

洗手对儿童健康的影响:随机对照试验

深入的随机对照试验: 从2011年1月至2013年3月由英国344名18岁以上英国全科医生医生招募20066名参与者。参与者被随机1:1分为两组,一组为基于网络干预洗手并进行调查问卷,另一组为对照组。另一部分人1:1随机分为两组,一组为网络干预但不进行调查问卷,另一组为对照组但会进行关于洗手的调查问卷。网络干预包括四周的网络课程,每周一次,通过不同的形式鼓励参与者,普及流感和洗手知识,让他们尽可能最大限度的洗手。16周后通过随访问卷且患流感的人数作为实验主要结果进行分析。

16908例(84%)参与者完成了为期16周的随访调查问卷,包括网络干预组8421人,对照组8667人。干预组4242例(占51%)的参与者在16周内发生了上呼吸道感染,对照组则为5135人(占59%), 多元风险比0.86,95%可信区间[CI]0.83 - -0.89;p < 0.0001。此外,干预组呼吸道感染症状持续天数对照组减少,分别为5.2±8.4天和6.5±9.0天,多元危险比0.91,95%置信区间0.87 - -0.95;p < 0.0001。网络干预组罹患消化道感染的人数也少许对照组。

原文出处:

Prof Paul Little, FMedSci.et al.An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised tria.l.the Lancet.2015

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    2016-03-01 qjddjq
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    2015-08-29 jiaoaoxiaoxu

    对的

    0

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    2015-08-15 zhmscau
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