DiVita 2011.

Study characteristics
Methods	The impact of hand‐washing promotion on the risk of household transmission of influenza, ILI, and fever was tested in rural Bangladesh. ILI was defined as fever in children < 5 years old and fever with cough or sore throat in individuals > 5 years old. Households were randomised to intervention or control. The intervention group received hand‐washing stations with soap and daily hand‐washing motivation at critical times for pathogen transmission, such as after coughing or sneezing. Daily surveillance was conducted, and household members with fever were tested for influenza viruses by PCR. Secondary attack ratios (SAR) were calculated for influenza, ILI, and fever in each arm. Logistic regression with generalised estimating equations was used to estimate the significance of the SAR comparison whilst controlling for clustering by household.
Participants	The study included 233 patient index cases (intervention group = 100, control group 133) with 2540 household contacts (intervention group = 134, control group = 1226). Inclusion criteria: index case patients (individuals who developed ILI within the previous 2 days and were the only symptomatic person in their household) as well as their household contacts
Interventions	Hand‐washing stations with soap and daily hand‐washing motivation versus control. See Table 4 for details.
Outcomes	SAR were calculated for influenza, ILI, and fever. ILI was defined as fever in children < 5 years old and fever with cough or sore throat in individuals > 5 years old. No safety outcomes reported.
Notes	Funding source unknown
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient details provided
Allocation concealment (selection bias)	Unclear risk	Insufficient details provided
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Insufficient details provided
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Insufficient details provided
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Insufficient details provided
Selective reporting (reporting bias)	Unclear risk	Insufficient details provided