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Use of non‐pharmaceutical interventions to reduce the transmission of influenza in adults: A systematic review
Author(s) -
Smith Sheree M.S.,
Sonego Sandra,
Wallen Gwenyth R.,
Waterer Grant,
Cheng Allen C.,
Thompson Philip
Publication year - 2015
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12541
Subject(s) - medicine , psychological intervention , blinding , randomized controlled trial , hygiene , transmission (telecommunications) , pandemic , environmental health , clinical study design , systematic review , family medicine , clinical trial , intensive care medicine , medline , covid-19 , disease , pathology , psychiatry , infectious disease (medical specialty) , political science , law , electrical engineering , engineering
Abstract During seasonal influenza epidemics and pandemics, virus transmission causes significant public health concern. Reduction of viral transmission by non‐pharmaceutical interventions ( NPI ) has a significant appeal and is often recommended. However, the efficacy of such interventions is unclear. A systematic literature review was undertaken to identify and evaluate the published literature on NPI efficacy to prevent human transmission of influenza virus in adults. Reviewers assessed the quality of eligible studies utilizing the C ritical A ppraisal S kills P rogramme for bias and the S cottish I ntercollegiate G uidelines N etwork for methodological quality. Studies were assessed for risk of bias domains of random sequence generation, allocation concealment, attribution bias, selective reporting and blinding. Relevant citations of 2247 were reduced to 100 for full‐text evaluation. Only seven met all selection criteria and pooled analysis was not feasible. Of the seven studies, two were randomized controlled trials ( RCT ) and five were cluster RCT . The main NPI studied were disinfection and hygiene; barriers; and combined NPI . However, these seven RCT had significant design flaws. Only two studies used laboratory confirmed influenza and poor statistical power was a major problem. Positive significant interventions included professional oral hygiene intervention in the elderly and hand washing. Despite the potential for NPI in preventing influenza transmission, there is very limited data available. Hand washing and dental hygiene may be useful, but other interventions have not been fully assessed. Properly designed studies evaluating large populations including ‘at risk’ patients and in a variety of communities are needed.