Effectiveness of a multifactorial handwashing program to reduce school absenteeism due to acute gastroenteritis

Pediatr Infect Dis J. 2014 Feb;33(2):e34-9. doi: 10.1097/INF.0000000000000040.


Background: Acute gastroenteritis (AGE) is one of the most common diseases among children and an important cause of school absenteeism. The aim of this study was to assess the effectiveness of a handwashing program using hand sanitizers for the prevention of school absenteeism due to AGE.

Methods: A randomized, controlled and open study of a sample of 1341 children between 4 and 12 years of age, attending 5 state schools in Almería (Spain), with an 8-month follow up (academic year). The experimental group (EG) washed their hands with soap and water, complementing this with the use of a hand sanitizer, and the control group (CG) followed the usual handwashing procedure. Absenteeism rates due GI were compared between the 2 groups through the multivariate Poisson regression analysis. Percent days absent in both groups were compared with a Z-test.

Results: 446 cases of school absenteeism due to AGE were registered. The school children from the EG had a 36% lower risk of absenteeism due to AGE (IRR: 0.64, 95% confidence interval: 0.52-0.78) and a decrease in absenteeism of 0.13 episodes/child/academic year (0.27 of EG vs 0.40 CG/episodes/child/academic year, P < 0.001). Pupils missed 725 school days due to AGE and absent days was significantly lower in the EG (EG: 0.31%, 95% confidence interval: 0.28-0.35 vs. CG: 0.44%, 95% confidence interval: 0.40-0.48, P < 0.001).

Conclusions: The use of hand sanitizer as a complement to handwashing with soap is an efficient measure to reduce absent days and the number of school absenteeism cases due to AGE.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Acute Disease
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Gastroenteritis / epidemiology
  • Gastroenteritis / prevention & control*
  • Hand Disinfection / methods*
  • Hand Sanitizers
  • Health Education / methods*
  • Humans
  • Male
  • Schools
  • Spain / epidemiology
  • Students / statistics & numerical data*


  • Hand Sanitizers