Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature
Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature
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DOI：
10.1186/1471-2458-8-153
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发表时间：
2008-05-08
影响因子：
4.5
通讯作者：
Morris, Peter
中科院分区：
文献类型：
--
作者：
McDonald, Elizabeth;Bailie, Ross;Morris, Peter
背景资料：生活在偏远社区的澳大利亚土著儿童仍然承受着常见传染病的沉重负担，这通常归因于卫生条件差和不卫生的生活条件。本系统性文献综述的目的是研究各种卫生和公共卫生干预策略（单独或组合）与常见可预防儿童传染病发生之间关系的流行病学证据。其目的是确定什么干预/S可能最有效地减少皮肤的发病率，腹泻和传染病的儿童生活在偏远的Indigenous communities.Methods：研究确定通过系统搜索电子数据库和手工搜索。研究类型仅限于科克伦协作有效实践和护理组织审查小组（EPOC）指南中包含的研究类型，审查人员使用相同的指南评估研究质量并提取数据。有资格的与会者包括土著居民和发展中国家居民。有资格列入的干预类型仅限于那些可能防止个人卫生和生活环境差造成的条件。结果：证据表明，有明确和强有力的证据表明，教育和用肥皂洗手，在预防儿童腹泻病的效果（一致的效果在四项研究）。在最大的精心设计的研究中，生活在使用普通肥皂并鼓励洗手的家庭中的儿童腹泻发病率降低了53%（95% CI，0.35，0.59）。有一些证据表明，教育和其他改变个人卫生行为的干预措施（6项研究）以及提供供水、环境卫生和个人卫生教育（2项研究）对降低腹泻发病率产生了影响。这些影响的大小是小的，质量的研究普遍poor.Conclusion：研究措施的卫生干预措施的有效性是复杂的，难以实施。多方面的干预措施（以用肥皂洗手为目标，包括水、环境卫生和个人卫生宣传）可能为改善偏远土著社区的儿童健康结果提供最大的机会。
Background: Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities.Methods: Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC) guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments.Results: The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies). In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59). There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies), as well as the provision of water supply, sanitation and hygiene education (two studies) on reducing rates of diarrhoeal disease. The size of these effects is small and the quality of the studies generally poor.Conclusion: Research which measures the effectiveness of hygiene interventions is complex and difficult to implement. Multifaceted interventions (which target handwashing with soap and include water, sanitation and hygiene promotion) are likely to provide the greatest opportunity to improve child health outcomes in remote Indigenous communities.