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Non-Pharmaceutical Measures to Reduce Influenza Transmission in Households: A Systematic Review and Meta-Analysis
29 Pages Posted: 3 May 2024
More...Abstract
Background: Influenza pandemic plans often recommend a number of non-pharmaceutical measures in household settings, including hand hygiene and face masks. We reviewed the evidence supporting recommendations of these measures to prevent the spread of influenza in households.
Methods: We reviewed the recommendations issued by national health authorities for the use of non-pharmaceutical measures in household settings during influenza epidemics or pandemics and identified a list of measures for the evidence review. We then performed systematic reviews on 26 May to 30 August 2022 in Medline, PubMed, EMBASE, and CENTRAL to identify evidence for the effectiveness of selected measures. We prioritized evidence from randomized controlled trials and excluded studies that were conducted in shared residences and institutions. Fixed-effects models were used to estimate the overall effects.
Findings: We selected nine non-pharmaceutical interventions for evidence review. We found nine studies related to hand hygiene and face masks in household settings. Some studies reported that measures could delay the introduction of influenza virus infections into households. However, no available evidence indicated that hand hygiene and face mask would have a substantial effect in preventing the spread of pandemic influenza within households.
Interpretation: The limited evidence indicated that within-household measures would likely only be effective when implemented before or as soon as possible after symptom onset in an infected case. Improving the evidence base for non-pharmaceutical interventions in households and elsewhere is a continuing priority, including for example evidence to support self-isolation policies.
Funding: This project was supported by a grant from the World Health Organization and the Strategic Topic Grants Scheme (Project No. STG4/M-701/23-N) of the Research Grants Council of the Hong Kong Special Administrative Region, China.
Declaration of Interest: B.J.C. has consulted for AstraZeneca, Fosun Pharma, GlaxoSmithKline, Haleon, Moderna, Novavax, Pfizer, Roche, and Sanofi Pasteur. All other authors report no potential conflicts of interest.
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