Abstract
The objectives were to (1) assess the prevalence of hand-washing practices across 80 countries and (2) assess frequency of hand-washing practice by economic status (country income and severe food insecurity), in a global representative sample of adolescents. Cross-sectional data from the Global School-based Student Health Survey 2003–2017 were analyzed. Data on age, sex, hand-washing practices in the past 30 days, and severe food insecurity (i.e., proxy of socioeconomic status) were self-reported. Multivariable logistic regression and meta-analysis with random effects based on country-wise estimates were conducted to assess associations. Adolescents (n = 209,584) aged 12–15 years [mean (SD) age 13.8 (1.0) years; 50.9% boys] were included in the analysis. Overall, the prevalence of hand-washing practices were as follows: never/rarely washing hands before eating (6.4%), after using toilet (5.6%), or with soap (8.8%). The prevalence of never/rarely washing hands after using the toilet (10.8%) or with soap (14.3%) was particularly high in low-income countries. Severe food insecurity was associated with 1.34 (95%CI = 1.25–1.43), 1.61 (95%CI = 1.50–1.73), and 1.44 (95%CI = 1.35–1.53) times higher odds for never/rarely washing hands before eating, after using the toilet, and with soap, respectively. A high prevalence of inadequate hand washing practices was reported, particularly in low-income countries and those with severe food insecurity. In light of the present COVID-19 pandemic and the rapid expansion being observed in low- and middle-income locations, interventions that disseminate good hand-washing practices are urgently required. Such interventions may also have cross-over benefits in relation to other poor sanitation-related diseases.
Highlights
Hand-washing with soap has been found to be an effective prevention strategy against the contraction of infectious diseases, including respiratory infections and gastrointestinal diseases
The GSHS was jointly developed by the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC), and other UN allies
As in a previous GSHS study, we considered those who answered ‘Most of the time’ or ‘Always’ as having severe food insecurity [18]
Summary
Hand-washing with soap has been found to be an effective prevention strategy against the contraction of infectious diseases, including respiratory infections and gastrointestinal diseases. COVID-19 is a respiratory virus that is transmitted by large respiratory droplets and direct contact with infected secretions
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