Hygiene Practices and Early Childhood Development in the East Asia-Pacific Region: A Cross-Sectional Analysis

Fanny Petermann-Rocha, Nirmala Rao, Manya Bala, Monika Parshad-Asnani, Anthony Sifuna, Aisha Yousafzai, Frederick K. Ho and Patrick Ip ()
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Fanny Petermann-Rocha: Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
Nirmala Rao: Faculty of Education, The University of Hong Kong, Hong Kong
Manya Bala: Faculty of Education, The University of Hong Kong, Hong Kong
Monika Parshad-Asnani: Sickle Cell Unit, Caribbean Institute for Health Research, The University of The West Indies, Kingston 7, Jamaica
Anthony Sifuna: Department of Medical Biochemistry, Masinde Muliro University of Science and Technology, Kakamega 50100, Kenya
Aisha Yousafzai: Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA 02115, USA
Frederick K. Ho: School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
Patrick Ip: Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong

IJERPH, 2023, vol. 20, issue 4, 1-12

Abstract: Poor hygiene might be a risk factor for early childhood development (ECD). This study investigated the associations of three hygiene practices (‘wash hands before a meal,’ ‘wash hands after going to the toilet,’ and ‘brush teeth’), separately and combined, with ECD. Six thousand six hundred ninety-seven children (4 [0.8] years) from the East Asia-Pacific Early Child Development Scales validation study were included in this cross-sectional analysis. The hygiene variables were recoded to have comparable values as ‘always,’ ‘sometimes,’ and ‘never.’ These variables were then grouped to create combined categories. The binary outcome variables, poor ECD, were defined as a score < age-specific 25th centile. Modified Poisson regression models were used to analyse the associations. Data collection was performed between 2012 and 2014, and the analyses were conducted in April 2022. Compared with children who ‘always’ washed their hands before a meal, those who did it ‘sometimes’ (Prevalence Ratio [PR]: 1.30 [95% CI: 1.16–1.46]) or ‘never’ (PR: 1.35 [1.18–1.55]) had a higher likelihood of poorer overall development. Comparable results were identified for the other two hygiene practices and the other four domain-specific outcomes ( p < 0.05). Compared with children who always followed the three hygiene practices, the likelihood of poor overall ECD increased as the combined hygiene practice decreased among children with poor hygiene practices (PR never : 1.67 [1.40–2.00]; PR rarely : 1.49 [1.30–1.71]; PR sometimes : 1.30 [1.14–1.49]). Children who did not always follow good hygiene practices had a higher likelihood of poor ECD independently of sociodemographic factors. Considering these findings, future hygiene practice interventions and trials should consider including ECD outcomes.

Keywords: hand hygiene; oral hygiene; child; growth and development; East Asia-Pacific region (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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