PDF(Pubmed)
Abstract：
Hand hygiene is an important measure to prevent disease transmission.
To summarise current international guideline recommendations for hand hygiene in community settings and to assess to what extent they are consistent and evidence based.
We included international guidelines with one or more recommendations on hand hygiene in community settings-categorised as domestic, public or institutional-published by international organisations, in English or French, between 1 January 1990 and 15 November 2021.
To identify relevant guidelines, we searched the WHO Institutional Repository for Information Sharing Database, Google, websites of international organisations, and contacted expert organisations and individuals.
Recommendations were mapped to four areas related to hand hygiene: (1) effective hand hygiene; (2) minimum requirements; (3) behaviour change and (4) government measures. Recommendations were assessed for consistency, concordance and whether supported by evidence.
We identified 51 guidelines containing 923 recommendations published between 1999 and 2021 by multilateral agencies and international non-governmental organisations. Handwashing with soap is consistently recommended as the preferred method for hand hygiene across all community settings. Most guidelines specifically recommend handwashing with plain soap and running water for at least 20 s; single-use paper towels for hand drying; and alcohol-based hand rub (ABHR) as a complement or alternative to handwashing. There are inconsistent and discordant recommendations for water quality for handwashing, affordable and effective alternatives to soap and ABHR, and the design of handwashing stations. There are gaps in recommendations on soap and water quantity, behaviour change approaches and government measures required for effective hand hygiene. Less than 10% of recommendations are supported by any cited evidence.
While current international guidelines consistently recommend handwashing with soap across community settings, there remain gaps in recommendations where clear evidence-based guidance might support more effective policy and investment.
To summarise current international guideline recommendations for hand hygiene in community settings and to assess to what extent they are consistent and evidence based.
We included international guidelines with one or more recommendations on hand hygiene in community settings-categorised as domestic, public or institutional-published by international organisations, in English or French, between 1 January 1990 and 15 November 2021.
To identify relevant guidelines, we searched the WHO Institutional Repository for Information Sharing Database, Google, websites of international organisations, and contacted expert organisations and individuals.
Recommendations were mapped to four areas related to hand hygiene: (1) effective hand hygiene; (2) minimum requirements; (3) behaviour change and (4) government measures. Recommendations were assessed for consistency, concordance and whether supported by evidence.
We identified 51 guidelines containing 923 recommendations published between 1999 and 2021 by multilateral agencies and international non-governmental organisations. Handwashing with soap is consistently recommended as the preferred method for hand hygiene across all community settings. Most guidelines specifically recommend handwashing with plain soap and running water for at least 20 s; single-use paper towels for hand drying; and alcohol-based hand rub (ABHR) as a complement or alternative to handwashing. There are inconsistent and discordant recommendations for water quality for handwashing, affordable and effective alternatives to soap and ABHR, and the design of handwashing stations. There are gaps in recommendations on soap and water quantity, behaviour change approaches and government measures required for effective hand hygiene. Less than 10% of recommendations are supported by any cited evidence.
While current international guidelines consistently recommend handwashing with soap across community settings, there remain gaps in recommendations where clear evidence-based guidance might support more effective policy and investment.
摘要：
背景：手部卫生是预防疾病传播的重要措施。
目的：总结当前关于社区环境中手部卫生的国际指南建议，并评估它们在多大程度上是一致的和基于证据的。
方法：我们纳入了国际指南，其中包含一项或多项关于社区环境中手部卫生的建议，由国际组织公开或机构出版，用英语或法语，1990年1月1日至2021年11月15日。
方法：为了确定相关指南，我们搜索了世卫组织机构信息共享数据库，Google,国际组织的网站，并联系专家组织和个人。
方法：将建议映射到与手卫生相关的四个领域：（1）有效的手卫生；（2）最低要求；（3）行为改变和（4）政府措施。评估了建议的一致性，一致性以及是否有证据支持。
结果：我们确定了多边机构和国际非政府组织在1999年至2021年之间发布的51条指南，其中包含923条建议。在所有社区环境中，用肥皂洗手一直被推荐为手部卫生的首选方法。大多数指南都特别建议用普通肥皂和自来水洗手至少20s；一次性纸巾用于干手；和基于酒精的手擦（ABHR）作为洗手的补充或替代。对洗手水质有不一致和不一致的建议,负担得起和有效的肥皂和ABHR的替代品，和洗手站的设计。关于肥皂和水量的建议存在差距，有效手部卫生所需的行为改变方法和政府措施。不到10％的建议得到任何引用证据的支持。
结论：虽然当前的国际指南一致建议在社区环境中使用肥皂洗手，在明确的循证指导可能支持更有效的政策和投资方面，建议仍然存在差距。
目的：总结当前关于社区环境中手部卫生的国际指南建议，并评估它们在多大程度上是一致的和基于证据的。
方法：我们纳入了国际指南，其中包含一项或多项关于社区环境中手部卫生的建议，由国际组织公开或机构出版，用英语或法语，1990年1月1日至2021年11月15日。
方法：为了确定相关指南，我们搜索了世卫组织机构信息共享数据库，Google,国际组织的网站，并联系专家组织和个人。
方法：将建议映射到与手卫生相关的四个领域：（1）有效的手卫生；（2）最低要求；（3）行为改变和（4）政府措施。评估了建议的一致性，一致性以及是否有证据支持。
结果：我们确定了多边机构和国际非政府组织在1999年至2021年之间发布的51条指南，其中包含923条建议。在所有社区环境中，用肥皂洗手一直被推荐为手部卫生的首选方法。大多数指南都特别建议用普通肥皂和自来水洗手至少20s；一次性纸巾用于干手；和基于酒精的手擦（ABHR）作为洗手的补充或替代。对洗手水质有不一致和不一致的建议,负担得起和有效的肥皂和ABHR的替代品，和洗手站的设计。关于肥皂和水量的建议存在差距，有效手部卫生所需的行为改变方法和政府措施。不到10％的建议得到任何引用证据的支持。
结论：虽然当前的国际指南一致建议在社区环境中使用肥皂洗手，在明确的循证指导可能支持更有效的政策和投资方面，建议仍然存在差距。
