Impact of Community Masking on COVID-19: A Cluster-randomized Trial in Bangladesh

Overview

Journal Science

Specialty Science

Date 2021 Dec 2

PMID 34855513

Citations 133

Authors

Jason Abaluck

Laura H Kwong

Ashley Styczynski

Ashraful Haque

Md Alamgir Kabir

Ellen Bates-Jefferys

Emily Crawford

Jade Benjamin-Chung

Shabib Raihan

Shadman Rahman

Salim Benhachmi

Neeti Zaman Bintee

Peter J Winch

Maqsud Hossain

Hasan Mahmud Reza

Abdullah All Jaber

Shawkee Gulshan Momen

Aura Rahman

Faika Laz Banti

Tahrima Saiha Huq

Stephen P Luby

Ahmed Mushfiq Mobarak

Affiliations

Soon will be listed here.

Abstract

We conducted a cluster-randomized trial to measure the effect of community-level mask distribution and promotion on symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in rural Bangladesh from November 2020 to April 2021 ( = 600 villages, = 342,183 adults). We cross-randomized mask type (cloth versus surgical) and promotion strategies at the village and household level. Proper mask-wearing increased from 13.3% in the control group to 42.3% in the intervention arm (adjusted percentage point difference = 0.29; 95% confidence interval = [0.26, 0.31]). The intervention reduced symptomatic seroprevalence (adjusted prevalence ratio = 0.91 [0.82, 1.00]), especially among adults ≥60 years old in villages where surgical masks were distributed (adjusted prevalence ratio = 0.65 [0.45, 0.85]). Mask distribution with promotion was a scalable and effective method to reduce symptomatic SARS-CoV-2 infections.

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