BACKGROUND We previously demonstrated that a hand hygiene program, including hand sanitizer and educational measures, for day care center (DCC) staff, children, and parents was more effective than a soap-and-water program, with initial observation, in preventing respiratory infections (RIs) in children attending DCCs. We analyzed the cost-effectiveness of these programs in preventing RIs. METHODS A cluster, randomized, controlled and open study of 911 children aged 0 to 3 years, attending 24 DCCs in Almeria. Two intervention groups of DCC-families performed educational measures and hand hygiene, one with soap-and-water (SWG) and another with hand sanitizer (HSG). The control group (CG) followed usual hand-washing procedures. RI episodes, including symptoms, treatments, medical contacts, complementary analyses, and DCC absenteeism days, were reported by parents. A Bayesian cost-effectiveness model was developed. RESULTS There were 5201 RI episodes registered. The adjusted mean societal costs of RIs per child per study period were CG: €522.25 (95% confidence interval [CI]: 437.10 to 622.46); HSG: €374.53 (95% CI: 314.90 to 443.07); SWG: €494.51 (95% CI: 419.21 to 585.27). The indirect costs constituted between 35.7% to 43.6% of the total costs. Children belonging to the HSG had an average of 1.39 fewer RI episodes than the CG and 0.93 less than the SWG. It represents a saving of societal cost mean per child per study period of €147.72 and €119.15, respectively. The HSG intervention was dominant versus SWG and CG. CONCLUSIONS Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents are more effective and cost less than a program with soap and water and initial observation in children attending DCCs.

中文翻译：

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托儿中心手部卫生计划在预防呼吸道感染方面的成本效益。

背景 我们之前已经证明，针对日间护理中心 (DCC) 工作人员、儿童和家长的手部卫生计划，包括洗手液和教育措施，在预防呼吸道感染方面比肥皂和水计划更有效，初步观察(RI) 在参加 DCC 的儿童中。我们分析了这些计划在预防 RI 方面的成本效益。方法 一项针对 911 名 0 至 3 岁儿童的集群、随机、对照和开放研究，参加了阿尔梅里亚的 24 个 DCC。DCC 家庭的两个干预组进行了教育措施和手部卫生，一个使用肥皂和水 (SWG)，另一个使用洗手液 (HSG)。对照组 (CG) 遵循通常的洗手程序。RI 发作，包括症状、治疗、医疗接触、补充分析和 DCC 缺勤天数，被家长举报了。开发了贝叶斯成本效益模型。结果 注册了 5201 个 RI 剧集。每个研究期间每个儿童 RI 的调整后平均社会成本为 CG：522.25 欧元（95% 置信区间 [CI]：437.10 至 622.46）；HSG：374.53 欧元（95% CI：314.90 至 443.07）；SWG：494.51 欧元（95% CI：419.21 至 585.27）。间接成本占总成本的 35.7% 至 43.6%。属于 HSG 的儿童的 RI 发作次数平均比 CG 少 1.39，比 SWG 少 0.93。它代表每个孩子每个学习期间平均节省的社会成本分别为 147.72 欧元和 119.15 欧元。与 SWG 和 CG 相比，HSG 干预占主导地位。结论 手卫生计划包括洗手液和针对 DCC 工作人员、儿童、