Respiratory infections and diarrhea are frequent among children in kindergartens. There is an agreement that interventions such as hand washing and other hygiene procedures are necessary, but research may help to identify which interventions that are the most effective and worth implementing. In this systematic review we have searched for and evaluated results from primary studies on the effect of infectious control interventions in kindergartens. Knowledge on effective infectious control interventions may lead to campaigns and guidelines for kindergartens.

The main findings from this systematic review are: Attention to hand hygiene practice compared to practice as usual

• reduces children’s incidence of diarrhea by 39 to 69%
• reduces respiratory tract infections by 17 to 43%
• reduces absenteeism rates by 4 to 20%.

A complex intervention that combines practical hand hygiene with training and facilitating hygiene routines

• reduces the incidence of diarrhea by 10 to 50%,
• reduces respiratory tract infections by 6 to 23%
• reduces the number of physician consultations by 13 to 26%
• reduces the prescription of antibiotics to children by 22 to 27%
• The intervention also has advantages for kindergarten staff, and it reduces parents’ absenteeism.

The effectiveness of initiatives concerning physical conditions (occupation density, time spent indoors/outdoors, space, ventilation, etc.) is uncertain. The documentation is of very low quality. This does not mean that the interventions do not work, but it means that the current scientific documentation lacks power to conclude about their effect.