Child Care Center Hand Hygiene Programs' Cost-Effectiveness in Preventing Respiratory Infections.
Por:
Azor-Martinez E, Garcia-Mochon L, Lopez-Lacort M, Strizzi JM, Muñoz-Vico FJ, Jimenez-Lorente CP, Fernandez-Campos MA, Bueno-Rebollo C, Del Castillo-Aguas G, Balaguer-Martinez JV and Gimenez-Sanchez F
Ahead of Print:
23 nov 2021
Resumen:
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: €522.25 (95% confidence interval [CI]: 437.10 to 622.46); HSG: €374.53 (95% CI: 314.90 to 443.07); SWG: €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 €147.72 and €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.
Filiaciones:
Azor-Martinez E:
Distrito Sanitario de Atención Primaria, Almería, Spain
Garcia-Mochon L:
Escuela Andaluza de Salud Pública, University of Granada, Granada, Spain
Center for Biomedical Research Network in Epidemiology and Public Health, Madrid, Spain
Institute of Biomedical Research Granada, University Hospitals of Granada, University of Granada, Granada, Spain
:
Vaccine Research Department, FISABIO-Public Health, Valencia, Spain
Strizzi JM:
Department of Public Health, University of Copenhagen, Copenhagen, Denmark
Muñoz-Vico FJ:
Unidad de Inmunología, Hospital Torrecardenas, Almería, Spain
Jimenez-Lorente CP:
Distrito Sanitario de Atención Primaria, Almería, Spain
Fernandez-Campos MA:
Distrito Sanitario de Atención Primaria, Almería, Spain
Bueno-Rebollo C:
Distrito Sanitario de Atención Primaria, Almería, Spain
Del Castillo-Aguas G:
Centro de Salud Colonia de Santa Ines, Distrito Sanitario de Atención Primaria Guadalhorce, Málaga, Spain
Balaguer-Martinez JV:
CAP St Ildefons, Cornellà de Llobregat, Barcelona, Spain
Gimenez-Sanchez F:
Instituto Hispalense de Pediatría, Instituto Balmis de Vacunas, Almeria, Spain
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