The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial
Background: There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationshi...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Journal of Infection and Public Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034123001223 |
| _version_ | 1797253957679054848 |
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| author | Aqel Albutti Hashim A. Mahdi Ameen S. Alwashmi Mohammad Alfelali Osamah Barasheed Elizabeth H. Barnes Ramon Z. Shaban Robert Booy Harunor Rashid |
| author_facet | Aqel Albutti Hashim A. Mahdi Ameen S. Alwashmi Mohammad Alfelali Osamah Barasheed Elizabeth H. Barnes Ramon Z. Shaban Robert Booy Harunor Rashid |
| author_sort | Aqel Albutti |
| collection | DOAJ |
| description | Background: There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationship between practising hand hygiene and rates of ARI in Umrah pilgrimage amidst the COVID-19 pandemic. Methods: A parallel RCT was conducted in hotels in Makkah, Saudi Arabia, between April and July 2021. Domestic adult pilgrims who consented to participate were randomised 1:1 to the intervention group who received alcohol-based hand rub (ABHR) and instructions, or to the control group who did not receive ABHR or instructions but were free to use their own supplies. Pilgrims in both groups were then followed up for seven days for ARI symptoms. The primary outcome was the difference in the proportions of syndromic ARIs among pilgrims between the randomised groups. Results: A total of 507 (control: intervention = 267: 240) participants aged between 18 and 75 (median 34) years were randomised; 61 participants were lost to follow-up or withdrew leaving 446 participants (control: intervention = 237:209) for the primary outcome analysis; of whom 10 (2.2 %) had developed at least one respiratory symptom, three (0.7 %) had ‘possible ILI’ and two (0.4 %) had ‘possible COVID-19′. The analysis of the primary outcome found no evidence of difference in the proportions of ARIs between the randomised groups (odds ratio 1.1 [0.3–4.0] for intervention relative to control). Conclusion: This pilot trial suggests that conducting a future definitive RCT to assess the role of hand hygiene in the prevention of ARIs is feasible in Umrah setting amidst such a pandemic; however, outcomes from this trial are inconclusive, and such a study would need to be very large given the low rates of outcomes observed here. Trial registration: This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12622001287729), the full protocol can be accessed there. |
| first_indexed | 2024-04-24T21:42:19Z |
| format | Article |
| id | doaj.art-23e43b9d753148bd8cac4e18be7a6744 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-04-24T21:42:19Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-23e43b9d753148bd8cac4e18be7a67442024-03-21T05:36:06ZengElsevierJournal of Infection and Public Health1876-03412024-04-01173441The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trialAqel Albutti0Hashim A. Mahdi1Ameen S. Alwashmi2Mohammad Alfelali3Osamah Barasheed4Elizabeth H. Barnes5Ramon Z. Shaban6Robert Booy7Harunor Rashid8Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia; Corresponding author.National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah 23442, Saudi ArabiaDepartment of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi ArabiaFamily and Community Medicine Department, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 25732, Saudi ArabiaThe Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi ArabiaNHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaNew South Wales Biocontainment Centre, New South Wales Ministry of Health, Westmead, NSW 2151, Australia; Faculty of Medicine and Health Susan Wakil School of Nursing, The University of Sydney, Sydney, NSW 2006, Australia; Public Health Unit, Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, AustraliaNational Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, AustraliaNational Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, AustraliaBackground: There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationship between practising hand hygiene and rates of ARI in Umrah pilgrimage amidst the COVID-19 pandemic. Methods: A parallel RCT was conducted in hotels in Makkah, Saudi Arabia, between April and July 2021. Domestic adult pilgrims who consented to participate were randomised 1:1 to the intervention group who received alcohol-based hand rub (ABHR) and instructions, or to the control group who did not receive ABHR or instructions but were free to use their own supplies. Pilgrims in both groups were then followed up for seven days for ARI symptoms. The primary outcome was the difference in the proportions of syndromic ARIs among pilgrims between the randomised groups. Results: A total of 507 (control: intervention = 267: 240) participants aged between 18 and 75 (median 34) years were randomised; 61 participants were lost to follow-up or withdrew leaving 446 participants (control: intervention = 237:209) for the primary outcome analysis; of whom 10 (2.2 %) had developed at least one respiratory symptom, three (0.7 %) had ‘possible ILI’ and two (0.4 %) had ‘possible COVID-19′. The analysis of the primary outcome found no evidence of difference in the proportions of ARIs between the randomised groups (odds ratio 1.1 [0.3–4.0] for intervention relative to control). Conclusion: This pilot trial suggests that conducting a future definitive RCT to assess the role of hand hygiene in the prevention of ARIs is feasible in Umrah setting amidst such a pandemic; however, outcomes from this trial are inconclusive, and such a study would need to be very large given the low rates of outcomes observed here. Trial registration: This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12622001287729), the full protocol can be accessed there.http://www.sciencedirect.com/science/article/pii/S1876034123001223Acute respiratory infectionsCOVID-19Hand hygieneMass gatheringPilgrimsRandomised controlled trial |
| spellingShingle | Aqel Albutti Hashim A. Mahdi Ameen S. Alwashmi Mohammad Alfelali Osamah Barasheed Elizabeth H. Barnes Ramon Z. Shaban Robert Booy Harunor Rashid The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial Journal of Infection and Public Health Acute respiratory infections COVID-19 Hand hygiene Mass gathering Pilgrims Randomised controlled trial |
| title | The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial |
| title_full | The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial |
| title_fullStr | The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial |
| title_full_unstemmed | The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial |
| title_short | The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial |
| title_sort | relationship between hand hygiene and rates of acute respiratory infections among umrah pilgrims a pilot randomised controlled trial |
| topic | Acute respiratory infections COVID-19 Hand hygiene Mass gathering Pilgrims Randomised controlled trial |
| url | http://www.sciencedirect.com/science/article/pii/S1876034123001223 |
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