TY - JOUR

T1 - Child Care Center Hand Hygiene Programs' Cost-Effectiveness in Preventing Respiratory Infections

AU - Azor-Martinez, Ernestina

AU - Garcia-Mochon, Leticia

AU - Lopez-Lacort, Monica

AU - Marie Strizzi, Jenna

AU - Javier Munoz-Vico, Francisco

AU - Pilar Jimenez-Lorente, Carmen

AU - Amparo Fernandez-Campos, Maria

AU - Bueno-Rebollo, Cristina

AU - del Castillo-Aguas, Guadalupe

AU - Vicent Balaguer-Martinez, Josep

AU - Gimenez-Sanchez, Francisco

PY - 2021

Y1 - 2021

N2 - BACKGROUND: We previously demonstrated that a hand hygiene program, including hand sanitizer and educational measures, for day care center (DCC) staff, children, and parents was more effective than a soap-and-water program, with initial observation, in preventing respiratory infections (RIs) in children attending DCCs. We analyzed the cost-effectiveness of these programs in preventing RIs.METHODS: A cluster, randomized, controlled and open study of 911 children aged 0 to 3 years, attending 24 DCCs in Almeria. Two intervention groups of DCC-families performed educational measures and hand hygiene, one with soap-and-water (SWG) and another with hand sanitizer (HSG). The control group (CG) followed usual hand-washing procedures. RI episodes, including symptoms, treatments, medical contacts, complementary analyses, and DCC absenteeism days, were reported by parents. A Bayesian cost-effectiveness model was developed.RESULTS: There were 5201 RI episodes registered. The adjusted mean societal costs of RIs per child per study period were CG: (sic)522.25 (95% confidence interval [CI]: 437.10 to 622.46); HSG: (sic)374.53 (95% CI: 314.90 to 443.07); SWG: (sic)494.51 (95% CI: 419.21 to 585.27). The indirect costs constituted between 35.7% to 43.6% of the total costs. Children belonging to the HSG had an average of 1.39 fewer RI episodes than the CG and 0.93 less than the SWG. It represents a saving of societal cost mean per child per study period of (sic)147.72 and (sic)119.15, respectively. The HSG intervention was dominant versus SWG and CG.CONCLUSIONS: Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents are more effective and cost less than a program with soap and water and initial observation in children attending DCCs.

AB - BACKGROUND: We previously demonstrated that a hand hygiene program, including hand sanitizer and educational measures, for day care center (DCC) staff, children, and parents was more effective than a soap-and-water program, with initial observation, in preventing respiratory infections (RIs) in children attending DCCs. We analyzed the cost-effectiveness of these programs in preventing RIs.METHODS: A cluster, randomized, controlled and open study of 911 children aged 0 to 3 years, attending 24 DCCs in Almeria. Two intervention groups of DCC-families performed educational measures and hand hygiene, one with soap-and-water (SWG) and another with hand sanitizer (HSG). The control group (CG) followed usual hand-washing procedures. RI episodes, including symptoms, treatments, medical contacts, complementary analyses, and DCC absenteeism days, were reported by parents. A Bayesian cost-effectiveness model was developed.RESULTS: There were 5201 RI episodes registered. The adjusted mean societal costs of RIs per child per study period were CG: (sic)522.25 (95% confidence interval [CI]: 437.10 to 622.46); HSG: (sic)374.53 (95% CI: 314.90 to 443.07); SWG: (sic)494.51 (95% CI: 419.21 to 585.27). The indirect costs constituted between 35.7% to 43.6% of the total costs. Children belonging to the HSG had an average of 1.39 fewer RI episodes than the CG and 0.93 less than the SWG. It represents a saving of societal cost mean per child per study period of (sic)147.72 and (sic)119.15, respectively. The HSG intervention was dominant versus SWG and CG.CONCLUSIONS: Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents are more effective and cost less than a program with soap and water and initial observation in children attending DCCs.

KW - ECONOMIC-EVALUATION

KW - DISEASE

KW - INTERVENTIONS

KW - ATTENDANCE

KW - SETTINGS

KW - ABSENCE

KW - BURDEN

KW - IMPACT

KW - RISKS

KW - HOME

U2 - 10.1542/peds.2021-052496

DO - 10.1542/peds.2021-052496

M3 - Journal article

C2 - 34814193

VL - 148

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 6

M1 - 2021052496

ER -