The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.

Children are susceptible to infections due to frequent participation in school group activities and their often-suboptimal hygiene practices. Frequent infections in children affect school attendance, academic performances, and general health. The effectiveness of school-based hygiene-related interve...

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Main Authors: Sophia Rasheeqa Ismail, Ranina Radzi, Puteri Sofia Nadira Megat Kamaruddin, Ezarul Faradianna Lokman, Han Yin Lim, Nusaibah Abdul Rahim, Hui Yin Yow, Daarshini Arumugam, Alex Ngu, Annie Ching Yi Low, Eng Hwa Wong, Sapna Patil, Priya Madhavan, Ruslin Bin Nordin, Esther van der Werf, Nai Ming Lai
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0308390
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author Sophia Rasheeqa Ismail
Ranina Radzi
Puteri Sofia Nadira Megat Kamaruddin
Ezarul Faradianna Lokman
Han Yin Lim
Nusaibah Abdul Rahim
Hui Yin Yow
Daarshini Arumugam
Alex Ngu
Annie Ching Yi Low
Eng Hwa Wong
Sapna Patil
Priya Madhavan
Ruslin Bin Nordin
Esther van der Werf
Nai Ming Lai
author_facet Sophia Rasheeqa Ismail
Ranina Radzi
Puteri Sofia Nadira Megat Kamaruddin
Ezarul Faradianna Lokman
Han Yin Lim
Nusaibah Abdul Rahim
Hui Yin Yow
Daarshini Arumugam
Alex Ngu
Annie Ching Yi Low
Eng Hwa Wong
Sapna Patil
Priya Madhavan
Ruslin Bin Nordin
Esther van der Werf
Nai Ming Lai
author_sort Sophia Rasheeqa Ismail
collection DOAJ
description Children are susceptible to infections due to frequent participation in school group activities and their often-suboptimal hygiene practices. Frequent infections in children affect school attendance, academic performances, and general health. The effectiveness of school-based hygiene-related intervention programmes need to be informed by updated high-quality synthesised evidence. In this systematic review, we searched PubMed and Cochrane CENTRAL for randomised and non-randomised interventional studies that evaluated school-based hygiene-related interventions. We assessed risk-of-bias (Cochrane risk-of-bias 2 tool), performed random-effect meta-analysis (RevMan 5.4) and rated certainty-of-evidence (GRADE). Thirty-nine trials (41 reports), published from 2011 to 2024 from 22 countries were included. Twenty-three studies contributed data for meta-analysis. All school-based interventions were compared with standard curriculum and demonstrated very low to low certainty-of-evidence due to study methodological limitations and imprecision. Hand-body hygiene interventions may improve knowledge, attitudes and practices (SMD 2.30, 95%CI 1.17 to 3.44, 6 studies, 7301 participants), increase handwashing practices (RR 1.75, 95%CI 1.41 to 2.17, 5 studies, 5479 participants), and reduce infection-related absenteeism (RR 0.74, 95%CI 0.66 to 0.83, 5 studies, 1017852 observations). Genital hygiene interventions may improve attitude (SMD 6.53, 95%CI 2.40 to 10.66, 2 studies, 2644 participants) and practices (RR 2.44, 95%CI 1.28 to 4.68, 1 study, 1201 participants). However, intervention effects on oral hygiene appeared mixed, with worsening of the oral hygiene score (SMD 3.12, 95%CI 1.87 to 4.37, 2 studies, 652 participants) but improved dental hygiene (SMD -0.33, 95%CI -0.53 to -0.13, 3 studies, 4824 participants) and dental caries scores (SMD -0.34, 95%CI -0.52 to -0.16, 4 studies, 2352 participants). Limited evidence suggests that interventions targeting hand-body and genital hygiene practices may improve knowledge, practices, and infection-related absenteeism. However, the effects on oral hygiene intervention appeared mixed. Future research should strengthen randomisation and intervention documentation, and evaluate hygiene-related behaviour, academic performances and health outcomes.
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spelling doaj-art-8ed6865e1aee475fb0b2d3ecda7758092025-08-20T03:06:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011910e030839010.1371/journal.pone.0308390The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.Sophia Rasheeqa IsmailRanina RadziPuteri Sofia Nadira Megat KamaruddinEzarul Faradianna LokmanHan Yin LimNusaibah Abdul RahimHui Yin YowDaarshini ArumugamAlex NguAnnie Ching Yi LowEng Hwa WongSapna PatilPriya MadhavanRuslin Bin NordinEsther van der WerfNai Ming LaiChildren are susceptible to infections due to frequent participation in school group activities and their often-suboptimal hygiene practices. Frequent infections in children affect school attendance, academic performances, and general health. The effectiveness of school-based hygiene-related intervention programmes need to be informed by updated high-quality synthesised evidence. In this systematic review, we searched PubMed and Cochrane CENTRAL for randomised and non-randomised interventional studies that evaluated school-based hygiene-related interventions. We assessed risk-of-bias (Cochrane risk-of-bias 2 tool), performed random-effect meta-analysis (RevMan 5.4) and rated certainty-of-evidence (GRADE). Thirty-nine trials (41 reports), published from 2011 to 2024 from 22 countries were included. Twenty-three studies contributed data for meta-analysis. All school-based interventions were compared with standard curriculum and demonstrated very low to low certainty-of-evidence due to study methodological limitations and imprecision. Hand-body hygiene interventions may improve knowledge, attitudes and practices (SMD 2.30, 95%CI 1.17 to 3.44, 6 studies, 7301 participants), increase handwashing practices (RR 1.75, 95%CI 1.41 to 2.17, 5 studies, 5479 participants), and reduce infection-related absenteeism (RR 0.74, 95%CI 0.66 to 0.83, 5 studies, 1017852 observations). Genital hygiene interventions may improve attitude (SMD 6.53, 95%CI 2.40 to 10.66, 2 studies, 2644 participants) and practices (RR 2.44, 95%CI 1.28 to 4.68, 1 study, 1201 participants). However, intervention effects on oral hygiene appeared mixed, with worsening of the oral hygiene score (SMD 3.12, 95%CI 1.87 to 4.37, 2 studies, 652 participants) but improved dental hygiene (SMD -0.33, 95%CI -0.53 to -0.13, 3 studies, 4824 participants) and dental caries scores (SMD -0.34, 95%CI -0.52 to -0.16, 4 studies, 2352 participants). Limited evidence suggests that interventions targeting hand-body and genital hygiene practices may improve knowledge, practices, and infection-related absenteeism. However, the effects on oral hygiene intervention appeared mixed. Future research should strengthen randomisation and intervention documentation, and evaluate hygiene-related behaviour, academic performances and health outcomes.https://doi.org/10.1371/journal.pone.0308390
spellingShingle Sophia Rasheeqa Ismail
Ranina Radzi
Puteri Sofia Nadira Megat Kamaruddin
Ezarul Faradianna Lokman
Han Yin Lim
Nusaibah Abdul Rahim
Hui Yin Yow
Daarshini Arumugam
Alex Ngu
Annie Ching Yi Low
Eng Hwa Wong
Sapna Patil
Priya Madhavan
Ruslin Bin Nordin
Esther van der Werf
Nai Ming Lai
The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.
PLoS ONE
title The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.
title_full The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.
title_fullStr The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.
title_full_unstemmed The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.
title_short The effects of school-based hygiene intervention programme: Systematic review and meta-analysis.
title_sort effects of school based hygiene intervention programme systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0308390
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