社区环境中手部卫生的最低材料要求：一项系统综述
Minimum material requirements for hand hygiene in community settings: a systematic review.
作者信息
O'Brien Lilly A, Files Kennedy, Snyder Jedidiah S, Rogers Hannah K, Cumming Oliver, Esteves Mills Joanna, Gordon Bruce, Freeman Matthew C, Caruso Bethany A, Wolfe Marlene K
机构信息
Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Woodruff Health Sciences Center Library, Emory University, Atlanta, Georgia, USA.
出版信息
BMJ Glob Health. 2025 Sep 16;10(Suppl 7):e018926. doi: 10.1136/bmjgh-2025-018926.
BACKGROUND
This systematic review assessed the minimum requirements necessary to create an enabling environment for sustained hand hygiene practices: quantity of water and soap, and number, spacing, location, and design of hand hygiene facilities.
METHODS
We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, PAIS Index, WHO IRIS, UN Digital Library and World Bank eLibrary, and consulted experts. Eligible studies were published through 29 March 2023, observational, in non-healthcare community settings, and reported on at least one of the five categories: (1) quantity of water, (2) quantity of soap, (3) location of hand hygiene materials, (4) number of users or spacing of facilities and (5) considerations for equitable access. Two reviewers independently extracted data from each study and assessed risk of bias using the Mixed Method Appraisal Tool.
RESULTS
This review identified 37 studies that met inclusion criteria from 27 countries, representing 4 of the 6 WHO regions (Africa, South-East Asia, the Americas and Europe). Household settings were the most represented (59% of studies), followed by institutional or school settings (41%) and public establishments (27%). Of the 37 studies, 12 (32%) assessed the relationship between a material requirement and hand hygiene practices. Despite extensive global research on hand hygiene, we found a lack of evidence linking material requirements with handwashing practices in community settings.
CONCLUSIONS
This review was limited to observational studies, and more data could be derived from experimental studies. Important evidence gaps include the quantity of water and soap needed, the influence of facility location and design on hand hygiene practice, and material needs providing equitable access. Further research is needed to strengthen the evidence base for hand hygiene recommendations and supplement the expert opinion on which many recommendations are currently based.
PROSPERO REGISTRATION NUMBER
CRD42023429145.
背景
本系统评价评估了为持续的手部卫生习惯创造有利环境所需的最低要求：水和肥皂的数量，以及手部卫生设施的数量、间距、位置和设计。
方法
我们检索了PubMed、科学网、EMBASE、护理学与健康领域数据库、全球卫生、考克兰图书馆、全球医学索引、Scopus、公共事务信息服务数据库索引、世界卫生组织信息资源信息系统、联合国数字图书馆和世界银行电子图书馆，并咨询了专家。纳入的研究发表于2023年3月29日之前，为观察性研究，在非医疗社区环境中进行，并报告了以下五个类别中至少一项：（1）水的数量，（2）肥皂的数量，（3）手部卫生用品的位置，（4）使用者数量或设施间距，以及（5）公平获取的考量因素。两名评审员独立从每项研究中提取数据，并使用混合方法评估工具评估偏倚风险。
结果
本评价确定了来自27个国家的37项符合纳入标准的研究，代表了世界卫生组织6个区域中的4个（非洲、东南亚、美洲和欧洲）。家庭环境的研究占比最大（59%），其次是机构或学校环境（41%）和公共场所（27%）。在这37项研究中，12项（32%）评估了物质需求与手部卫生习惯之间的关系。尽管全球对手部卫生进行了广泛研究，但我们发现缺乏证据表明社区环境中的物质需求与洗手习惯之间存在关联。
结论
本评价仅限于观察性研究，更多数据可来自实验性研究。重要的证据空白包括所需水和肥皂的数量、设施位置和设计对手部卫生习惯的影响，以及提供公平获取的物质需求。需要进一步研究以加强手部卫生建议的证据基础，并补充目前许多建议所基于的专家意见。
国际前瞻性系统评价注册编号
CRD42023429145。
Zotero 插件