French Military Center for Epidemiology and Public Health, Marseille, France.
French Military Center for Epidemiology and Public Health, Marseille, France.
Travel Med Infect Dis. 2017 Jan-Feb;15:48-51. doi: 10.1016/j.tmaid.2016.11.007. Epub 2016 Nov 23.
Acute diarrhea remains a public health concern in armed forces deployed in tropical areas where access to water and soap is limited. This study aims to assess the effectiveness of alcohol-based hand rubs (ABHR) on incidence of diarrhea in poor hygiene conditions.
A prospective randomized trial was conducted between November 2014 and January 2015 among French military troops deployed in Africa to compare a group of soldiers receiving usual hand hygiene recommendations (control group), to a group of soldiers who received ABHR in addition to usual hand hygiene recommendations (intervention group). Data on diarrhea and hygiene behaviors were collected using self-questionnaires. The incidence rate of diarrhea episodes in groups was compared.
Participation rate was 59% (236/400). The proportion of individuals who used ABHR was 97% in the intervention group and 62% in the control group. The overall incidence rate of diarrheal episodes was observed to be in the region of 60 per 100 persons-month without any significant difference between groups after adjustment on confounding factors (p = 0.93). Handwashing with soap was used on average 4 times a day in the control group and twice a day in the intervention group (p = 0.93). It was the only significant protective factor for diarrhea (p < 10).
Our results support that supplying soap and good quality water should be a priority on the field.
在水资源和肥皂供应有限的热带地区部署的武装部队中，急性腹泻仍然是一个公共卫生关注点。本研究旨在评估酒精基手部消毒剂（ABHR）在卫生条件较差的情况下对腹泻发病率的影响。
2014 年 11 月至 2015 年 1 月期间，在部署在非洲的法国军队中进行了一项前瞻性随机试验，将接受常规手部卫生建议的一组士兵（对照组）与接受 ABHR 加常规手部卫生建议的一组士兵（干预组）进行比较。使用自我问卷收集腹泻和卫生行为数据。比较两组腹泻发作的发生率。
参与率为 59%（236/400）。干预组中使用 ABHR 的比例为 97%，对照组为 62%。在调整混杂因素后，两组之间的腹泻发作总体发生率无显著差异（p=0.93），为每 100 人-月 60 例。对照组平均每天洗手 4 次，干预组每天洗手 2 次（p=0.93）。这是唯一对腹泻有显著保护作用的因素（p<10）。
我们的结果支持在现场优先供应肥皂和优质水。
