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RCOG World Congress 2025

June 23 - 25, 2025 | ExCeL London, UK

EP.0654

Alcohol handrub to prevent infant illness in Uganda; a community randomised trial.

Poster Presenter

Andrew Weeks

Authors

Martin Chebet, David Mukunya, Kathy Burgoine, Melf-Jacob Kuhl, Duolao Wang, Antonieta Medina-Lara, Brian Faragher, Amos Odit, Peter Olupot-Olupot, Ingunn Marie Stadskleiv Engebretsen, John Baptist Waniaye, Julius Wandabwa, Thorkild Tylleskar, Andrew Weeks

Affiliations

University of Liverpool, Ministry of Health, Liverpool School of Tropical Medicine, Busitema University, University of Bergen, University of Exeter, Ngora Freda Carr Hospital, Sanyu Africa Research Institute, Mbale Regional Referral Hospital

Part of Topic

Global health/health policy

Provision of alcohol based handrub (ABHR) to mothers does not prevent severe illness and death in Ugandan infants: a community cluster randomised trial

Objective

-To determine whether provision of ABHR to pregnant women to be used before touching the baby prevents severe illness and death among infants up to three months of age.

Methodology

-Phase 3, open label, two-arm parallel cluster superiority randomised trial
-72 villages (clusters) in Eastern Uganda. Target cluster size: 850 people, excluding villages inaccessible by motorcycle during the wet season. Distance between clusters was at least 2 km
-Publicly randomised to receive 6 litres ABHR or standard care, stratified by cluster size
-We recruited pregnant women at least 34 weeks of gestation, residing in the clusters.
-Identified by Village Health team members and enrolled by research midwives
-All received chlorhexidine for cord care and a Maama birthing kit.
-Followed-up to 3 months postnatally
-Primary outcome: severe illness or death
-Secondary outcomes: individual infections and community hygiene practices
 

Results

−We enrolled 6,089 pregnant women between January 2021 and September 2023; 5,791 had available data
−Participants from both arms had similar baseline characteristics.
−Intention to treat analysis: proportion of infants with severe illness or death was 17.4% (477/2749) in intervention arm and 16.4% (499/3042) in the control arm (adjusted risk ratio 1.05, 95% confidence interval 0.92 to 1.20; p = 0.49).
−No difference in occurrence of individual outcomes, and no treatment related harms
−Women in the intervention clusters reported significantly more hand cleaning
 

Conclusion

    Providing alcohol handrub to women for hand hygiene improved hand hygiene episodes but had no effect on severe illness or death in infants up to 3 months old.

 Implications:

    The current practice of hand washing with soap and water should continue to be promoted.

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