Study: Only One in Three Adolescents Practice Appropriate Hand Hygiene

by johnsmith

Among 354,422 adolescents from 92 low- to middle- and high-income countries, only 30.3% were found to practice appropriate hand hygiene.

Jatrana et al. demonstrated suboptimal hand hygiene practice in adolescents. Image credit: Manuel Darío Fuentes Hernández.

Jatrana et al. demonstrated suboptimal hand hygiene practice in adolescents. Image credit: Manuel Darío Fuentes Hernández.

Over 150 years ago, the Hungarian physician and scientist Ignaz Semmelweiss first demonstrated the effectiveness of a seemingly simple intervention, hand washing, in preventing healthcare-associated infections.

Since then, hand washing with soap and water at key times is heralded as one of the most cost-effective measures to reduce the global burden of gastrointestinal and respiratory diseases.

While examining the population hand hygiene practices is of interest in its own right, it is particularly important to explore these practices in young people, as they are the ‘silent carriers’ who unknowingly play a major role in community transmission of infections.

“There was a renewed emphasis on adequate hand hygiene with COVID-19,” said Dr. Yaqoot Fatima, a researcher in the Institute for Social Science Research at the University of Queensland and the Centre for Rural and Remote Health at James Cook University.

“We used data from the Global School-based Student Health Survey from 92 countries across the six WHO regions to examine the prevalence and correlation of hand hygiene practices in adolescents worldwide.”

“Our results highlight that globally, adolescents practice suboptimal hand hygiene.”

The researchers examined 354,422 adolescents (13-17 years) from the Global School-based Student Health Survey.

Hand hygiene practices were categorized as ‘appropriate,’ ‘inappropriate’ and ‘lacking’ based on the information about ‘hand washing before eating,’ ‘hand washing after using the toilet,’ and ‘hand washing with soap.’

Globally, only 30.3% reported practicing appropriate hand hygiene, whereas 60.4% and 9.4% of the adolescents reported practicing inappropriate hand hygiene and lack of hand hygiene, respectively.

The study also showed that both school (bullying, exercise) and family-level factors (parental supervision and parental bonding) influence hand hygiene practices.

“Although access to soap and water was an issue, around 60% of adolescents were not practising appropriate hand hygiene even when they had access to water and soap,” Dr. Fatima said.

“While access to handwashing facilities and knowledge of proper hygiene is important for practising adequate hand hygiene, the study showed that the knowledge-behavior gap is a major reason for sub-optimal hand hygiene practices.”

The findings were published in the International Journal of Environmental Research and Public Health.


Santosh Jatrana et al. 2021. Global Variation in Hand Hygiene Practices Among Adolescents: The Role of Family and School-Level Factors. Int. J. Environ. Res. Public Health 18 (9): 4984; doi: 10.3390/ijerph18094984

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