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. 2020 Nov 20;2020(11):CD006207. doi: 10.1002/14651858.CD006207.pub5

3. Results from trials of hand hygiene + medical/surgical masks compared to control.

Study Comparison (see Table 4 for details of interventions) Reported outcomes Results
Aelami 2015 (conference abstract)
RCT
Saudi Arabia
Hand hygiene education + alcohol‐based hand rub + soap + surgical masks vs none Proportion with ILI (defined as presence of ≥ 2 of the following during their stay: fever, cough, and sore throat) 52% in intervention; 55.3% in control (P < 0.001)
Aiello 2010
cluster‐RCT
USA
Face mask use (FM) vs face masks + hand hygiene (FM + HH) vs control
Note that this study is not included in meta‐analysis as each treatment group included only 1 cluster.
1. ILI
2. Laboratory‐confirmed influenza A or B Significant reduction in ILI cases in both intervention groups compared with control over weeks 3 to 6
No significant differences between FM and FM + HH
Aiello 2012
cluster‐RCT
USA
Face mask use (FM) vs face masks + hand hygiene (FM + HH) vs control 1. Clinical ILI
2. Laboratory‐confirmed influenza A or B 1. Non‐significant reductions in FM group compared with control over all weeks. Significant reduction in FM + HH group compared with control in weeks 3 to 6
2. Non‐significant reductions in both intervention groups compared with control
Cowling 2009
cluster‐RCT
Hong Kong
Hand hygiene (HH) vs hand hygiene plus face masks (HH + mask) vs control Secondary attack ratio for:
1. laboratory‐confirmed influenza;
2. ILI definition 1;
3. ILI definition 2. 1. HH 5; HH + mask 7; control 10
2. HH 16; HH + mask 21; control 19
3. HH 4; HH + mask 7; control 5
Larson 2010
cluster‐RCT
USA
Education (control) vs education with alcohol‐based hand sanitiser (HS) vs education + HS + face masks (HS + mask) Incidence rate ratios (episodes per 1000 person‐weeks) for:
1. URI;
2. ILI;
3. influenza.
Secondary attack rates for:
4. URI/ILI/influenza;
5. ILI/influenza.
1. HS 29; HS + mask 39; control 35
2. HS 1.9; HS + mask 1.6; control 2.3
3. HS 0.6; HS + mask 0.5; control 2.3
4. HS 0.14; HS + mask 0.12; control 0.14
5. HS 0.02; HS + mask 0.02; control 0.02
Simmerman 2011
cluster‐RCT
Thailand
Control vs hand‐washing (HW) vs hand‐washing + paper surgical face masks (HW + mask) Odds ratio for secondary attack rates for influenza OR for HW: control 1.20 (95% CI 0.76 to 1.88)
OR for HW + mask: control 1.16 (95% CI 0.74 to 1.82)
OR for HW + mask: HW 0.72 (95% CI 0.21 to 2.48)
Suess 2012
cluster‐RCT
Germany
Face mask + hand hygiene (mask + HH) vs face masks only (mask) vs none (control) Secondary attack rates in household contacts:
1. Laboratory‐confirmed influenza
2. ILI 1. Mask 9; mask + HH 15; control 23
2. Mask 9; mask + HH 9; control 17

CI: confidence interval
cluster‐RCT: cluster‐randomised controlled trial
FM: face mask
HH: hand hygiene
HS: hand sanitiser
HW: hand‐washing
ILI: influenza‐like illness
OR: odds ratio
RCT: randomised controlled trial
URI: upper respiratory infection