1233. Reduction in Acute Respiratory Infection among Military Trainees: Secondary Effects of a Hygiene-based Cluster-Randomized Trial for Skin and Soft Tissue Infection Prevention
Session: Poster Abstract Session: Clinical Infectious Diseases: Respiratory Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • 1233_IDWPOSTER.pdf (154.7 kB)
  • Background:

    Prevention of acute respiratory infection (ARI) among military trainees is needed. In a trial of personal hygiene for skin and soft tissue infection (SSTI), we evaluated the secondary impact on ARI.

    Methods:

    A group-randomized SSTI prevention trial was conducted among Army trainees at Fort Benning, GA from 2010-2012. There were three groups, each with ~10,000 trainees. Each group (Standard [S], Enhanced Standard [ES], and Chlorhexidine [CHG]) was assigned an intervention consisting of incrementally increasing personal hygiene measures. S received a briefing on personal hygiene practices and SSTI prevention. ES received the S components in addition to supplemental educational materials. CHG received the ES components in addition to CHG-based body wash (Hibiclens) they were instructed to use once weekly. We reviewed ICD-9 codes in an outpatient database to identify medically-attended cases of ARI. Data abstractors were blind to group assignment.

    Results: 

    Over a 20-month period and among ~30 000 trainees, 13,949 episodes of ARI were identified, 4,365 (31.3%) in the S group, 4,426 (31.7%) in the ES group, and 5,158 (36.9%) in the CHG group. The overall ARI rate was 33.9 (95% CI: 33.3, 34.5) cases per 1000 person-weeks. By study group, ARI rates were 35.3 (95% CI: 34.3, 36.3), 29.3 (95% CI: 28.5, 30.2), and 37.7 (95% CI: 36.7, 28.7) per 1000 person-weeks in the S, ES and CHG groups, respectively. When compared to the S group, ARI rates were lower in the ES (RR: 0.82; 95% CI: 0.80, 0.87) group but not in the CHG (RR: 1.07; 95% CI: 1.03, 1.11) group. Rates were highest during the winter, 38.3 (95% CI: 36.8, 40.0) cases per 1000 person-weeks. ARI rates in the winter did not differ between the ES and S groups (RR: 0.93; 95% CI: 0.84, 1.03), but were higher in the CHG as compared to the S groups (RR: 1.33; 95% CI: 1.20-1.48).

    Conclusion:

    Promotion of personal hygiene among military trainees was associated with a reduction in ARI. CHG did not have added benefit for ARI prevention. Routine practice of personal hygiene, especially hand hygiene, may reduce rates of ARI and other infectious diseases common among military trainees.

    Eugene Millar, PhD1, Carey Schlett, MPH1, Natasha Law, MA2, Wei-Ju Chen, PhD1, Michael D’Onofrio, MD, MPH3, Jason Bennett, MD, MSPH4, Jeffrey Lanier, MD5, David Tribble, MD, DrPH, FIDSA1 and Michael Ellis, MD6, (1)Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, Rockville, MD, (2)Infectious Disease Clinical Research Program, Martin Army Community Hospital, Fort Benning, GA, (3)Medical Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, (4)Department of Medicine, Uniformed Services University, Bethesda, MD, (5)Family Medicine, Martin Army Community Hospital, Fort Benning, GA, (6)University of Toledo College of Medicine and Life Sciences, Toledo, OH

    Disclosures:

    E. Millar, None

    C. Schlett, None

    N. Law, None

    W. J. Chen, None

    M. D’Onofrio, None

    J. Bennett, None

    J. Lanier, None

    D. Tribble, None

    M. Ellis, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.