Hand-Washing Practices among Adolescents Aged 12–15 Years from 80 Countries

Lee Smith, Laurie Butler, Mark A Tully, Louis Jacob, Yvonne Barnett, Guillermo F. López-Sánchez, Rubén López-Bueno, Jae Il Shin, Daragh McDermott, Briona A. Pfeifer, Damiano Pizzol and Ai Koyanagi
Additional contact information
Lee Smith: The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
Laurie Butler: Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
Mark A Tully: Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK
Louis Jacob: Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France
Yvonne Barnett: Faculty of Science and Technology, Anglia Ruskin University, Cambridge CB1 1PT, UK
Guillermo F. López-Sánchez: Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge CB1 1PT, UK
Rubén López-Bueno: Department of Physical Medicine and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
Jae Il Shin: Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 120-752, Korea
Daragh McDermott: School of Psychology and Sport, Anglia Ruskin University, Cambridge CB1 1PT, UK
Briona A. Pfeifer: The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
Damiano Pizzol: Italian Agency for Development Cooperation, Khartoum 79371, Sudan
Ai Koyanagi: Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ICREA, Sant Boi de Llobregat, 08830 Barcelona, Spain

IJERPH, 2020, vol. 18, issue 1, 1-15

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.

Keywords: hand-washing; hygiene; epidemiology; adolescents; poverty; multi-country study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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