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THE PREVALENCE OF HAND HYGIENE AMONG UNDERGRADUATE STUDENTS IN A DEVELOPING COUNTRY

1.0 INTRODUCTION

One of the effective measures to control the infectious disease is by hand washing. Hand washing is a key health promotion strategy in public health. It has an ancient origin but is still very effective, convenient, and cost-effective in the prevention of diseases today (Sultana et al., 2016). Worldwide, almost 4 million children under age 5 suffer from infectious diseases like diarrhea due to poor hygiene practices (Sultana et al., 2016).  According to estimations about 2.5 million deaths, every year would have been prevented by good hygiene practice, sanitation, and clean drinking water (Sultana et al., 2016).

The World Health Organization has defined hand washing as an activity that involves the cleansing of hands; it could be with or without water, or any other liquid, or with soap to get rid of soil, dirt, or microorganisms (Sultana et al., 2016). There exists a strong relationship between good hand hygiene practice and infectious diseases (Sultana et al., 2016). Several meta-analysis studies have reported that adequate and improved hand hygiene is strongly associated with a reduction in respiratory infections and gastrointestinal diseases (Sultana et al., 2016). Hand hygiene also implies rubbing alcohol-based sanitizers when one's hands are not dirty/soiled for 20-30 seconds (The Global Public-Private Partnership, 2014; Bouwer et al., 2018). But as for visibly soiled hands, it is appropriate to use soap and water to wash the hands for about one minute (The Global Public-Private Partnership; 2014; Bouwer et al., 2018). It is also important to note that after rubbing alcohol-based sanitizers, you are not expected to wash your hands immediately (The Global Public-Private Partnership, 2014; Bouwer et al., 2018). These guidelines are provided by the World Health Organization (Sultana et al., 2016).

Although the beneficial importance of handwashing has been stressed a lot on its major role in the prevention of infectious diseases, however, its practice is very minimal in developing nations, thereby adding to the disease burden of infectious diseases in such countries (Sultana et al., 2016). Imagine that a survey in one of the developing countries showed that washing hands with soap and water before taking meals was very low when compared to after defecation. It also shows that only 14% practice proper handwashing. Such studies indicate that it is not just being aware of handwashing and its importance, rather good knowledge of proper handwashing hygiene is very important to improve handwashing practice. This does not just happen in one country, it is a major problem in several developing countries, and worldwide (Sultana et al., 2016). 

Good Handwashing hygiene has been proven to be significantly beneficial for university students. Several studies have shown that inappropriate hand hygiene is associated with the student's academic performance (Sultana et al., 2016).  Increased absenteeism due to infectious diseases (gastrointestinal disease and respiratory infections) has been reported to contribute to low academic performance (Sultana et al., 2016). These infectious diseases (gastrointestinal disease and respiratory infections) are known commonly to be contracted due to inappropriate handwashing hygiene practices. In addition, nosocomial infections have also been on the rise in the world recently, which is greatly associated with poor hand washing hygiene (Shehu et al., 2019; Nawab, et al., 2015). Medical and nursing undergraduate students are found in this environment, thereby making them susceptible to these infections (Veena et al., 2014). This is an issue in developed nations and a much greater issue in developing nations (Shehu et al., 2019). The prevalence rate of these infections is over 25% with an increase in death rates. This could have been prevented by proper handwashing practice.

One of the contributory factors to inappropriate handwashing hygiene practice among undergraduate students has been associated with a lack of infrastructural facilities for handwashing (running tap water, handwashing basins, soaps, sanitizers) in the university environment (Sultana et al., 2016; Nawab et al., 2015). Another contributory factor is the lack of public health education programs on handwashing hygiene (Sultana et al., 2016). Güran & Akçay study among undergraduate nursing students in North Cyprus showed a high perception level of hand hygiene and they suggested that educational programs are driving factor in achieving improved hand hygiene practice (Güran & Akçay, 2020).

Another study in Saudi Arabia among medical undergraduates showed that the student's curriculum does not provide the necessary information on hand hygiene, which explains the gap between knowledge and practice of hand hygiene (Bouwer et al., 2018). The study concluded that the students have a poor level of knowledge regarding good hand hygiene practice, which was also reported in other similar studies (Bouwer et al., 2018; Ademuyiwa et.al. 2019). Another study also showed that poor knowledge of good hand hygiene practice is another factor that affects the practice of good hand washing among university students (Bouwer et al., 2018). There are limited studies on the prevalence of hand hygiene practice among undergraduate students in a developing country, which this present study will aim to achieve.

1.1 AIM

  • To determine the prevalence of hand hygiene practice among undergraduates’ students in a developing country

1.2 SPECIFIC OBJECTIVES

  • To assess the level of knowledge of hand hygiene among undergraduates’ students in a developing country
  • To assess the level of practice of hand hygiene among undergraduates’ students in a developing country
  • To determine the factors affecting hand hygiene among undergraduates’ students in a developing country

1.3 PROBLEM STATEMENT

The issue of hand hygiene is a major problem in developing countries and among university students. The level of knowledge about hand hygiene determines the level of hand hygiene practice. Several studies have shown that inappropriate hand hygiene is associated with the student’s academic performance (Sultana et al., 2016).  Increased absenteeism due to infectious diseases (gastrointestinal disease and respiratory infections) has been reported to contribute to low academic performance (Sultana et al., 2016). According to estimations about 2.5 million deaths, every year would have been prevented by good hygiene practice, sanitation, and clean drinking water (Sultana et al., 2016).  Therefore, it is necessary to study the prevalence of hand hygiene practice to help proffer information that will help improve hand hygiene practice in a developing country.

1.4 RESEARCH QUESTIONS

  • What is the level of knowledge of hand hygiene among undergraduate students in a developing country?
  • What is the level of practice of hand hygiene among undergraduate students in a developing country?
  • What are the factors affecting hand hygiene among undergraduate students in a developing country?

1.5 SIGNIFICANCE OF STUDY

This study is very important because understanding the prevalence level of hand hygiene practice among undergraduate students is a good approach to prevent diseases such as nosocomial infections, respiratory infections, and gastrointestinal diseases in a developing nation, For example, nosocomial infections have also been on the rise in the world recently, which is greatly associated with poor hand washing hygiene (Shehu et al., 2019; Nawab, et al., 2015). Medical and nursing undergraduate students are found in this environment, thereby making them susceptible to these infections (Veena et al., 2014). This is an issue in developed nations and a much greater issue in developing nations (Shehu et al., 2019). The prevalence rate of these infections is over 25% with an increase in death rates. This could have been prevented by proper handwashing practice. Therefore, it is necessary to study the prevalence of hand hygiene practice to help proffer information that will help improve hand hygiene practice in a developing country.

1.6 METHODOLOGY

  • Study design/Sampling/Collection

This will be a cross-sectional study among undergraduate students in a university in a developing country. A pretested structured questionnaire will be used to collect all relevant information using simple random sampling.

1.7 ANALYSIS

Collected data from the questionnaire will be entered into SPSS version 20 for analysis. Adjusted odds ratios (OR) with a 95% confidence interval will be used to assess statistically significant variables (p<0.05).

1.8 RISK ASSESSMENT

The risk assessment conducted for this project is provided in the table below:

Table 1:  Risk assessment

Risk

Impact

Mitigation Plan

Inability to meet the deadline

Low

Get an extension from the supervisor in due time

Inability to get required process inputs, skill, and manpower

Moderate

Refer to municipalities and research institutes for help

Inability to properly develop the process set up

High

Refer to your supervisor for help

Insufficient data

Low

Refer to journals and textbooks for help

1.9 SCHEDULE

    Table 2: Project Plan

Task Name

Start Date

End Date

Duration (Days)

Initial Research

15/01/2022

29/01/2022

14

Proposal

29/01/2022

06/02/2022

21

Introduction Chapter

18/03/2022

23/03/2022

5

Literature Review Chapter

23/03/2022

20/04/2022

24

Methodology Chapter

20/04/2022

02/05/2022

12

Presentation 1

02/07/2022

10/07/2022

8

Analysis

10/07/2022

24/07/2022

14

Evaluation of Gotten Results

24/07/2022

01/08/2022

7

Discussion Chapter

01/08/2022

11/08/2022

10

Evaluation Chapter

11/08/2022

16/08/2022

5

Conclusion Chapter

16/08/2022

18/08/2022

2

Project Management Chapter

18/08/2022

20/08/2022

2

Abstract and Report compilation

20/08/2022

22/08/2022

2

Report Proofreading

22/08/2022

01/09/2022

10

Presentation 2

01/09/2022

11/09/2022

10

REFERENCES

Ademuyiwa, I.Y., Farotimi, A.A., Afolabi, A.W. and  Quadri, Y.O. (2019). Knowledge and Practice of Hand Hygiene among Undergraduate Nurses in College of the Medicine University of Lagos. International Journal of Health Sciences & Research (www.ijhsr.org) 97 Vol.9; Issue: 12;

Bouwer, M., Labuschagne, S., Spamer, S., Vermaak, C., Zietsman, L. M., Steyn, D., & Joubert, G. (2018). Knowledge of final-year medical students at the University of the Free State of hand hygiene as a basic infection control measure. South African Family Practice, 60(3), 74–78. https://doi.org/10.1080/20786190.2017.1396789

Güran, M., & Akçay, N. ?. (2020). Hand hygiene as an incomplete challenge for developing countries: Discussions based on knowledge and perceptions of nurses in North Cyprus example and published studies. Marmara Medical Journal, 33(2), 67–74. https://doi.org/10.5472/marumj.737740

Nawab, T., Mehnaz, S, Abedi-Safui, S.R., Khalique, M, Ansari, A. & Khan, Z. (2015) Knowledge, Attitude and Practice of Hand Hygiene among Medical and Nursing Students in a Tertiary Hospital in India. International Journal of Sciences and Applied Research, 2 (6): 29-39.

Shehu, N. Y., Onyedibe, K. I., Igbanugo, J. S., Okolo, M. O., Gomerep, S. S., Isa, S. E., & Egah, D. Z. (2019). Hand hygiene knowledge, training, and practice: A cross-sectional study in a tertiary health institution, North-central Nigeria. Nigerian Journal of Clinical Practice, 22(7), 1008–10

Sultana, M., Alam Mahumud, R., Razzaque Sarker, A., & Mahmud Hossain, S. (2016). Hand hygiene knowledge and practice among university students: Evidence from private universities of Bangladesh. Risk Management and Healthcare Policy, 9, 13–20. https://doi.org/10.2147/RMHP.S98311

The Global Public-Private Partnership. (2014) About Hand washing, 2014. Retrieved from www.globalhandwashing.org/about-handwashing/why-handwashing/.

Veena, M., Navin- Chandra, M., kaore, Vijay, K.R., Sanjay, K.G., Amod, B. & Rituja, K. (2014) A Study to Assess Knowledge and Attitude Regarding Hand Hygiene amongst Residents and Nursing Staff in a Tertiary Health Care Setting of Bhopal City. J Clin Diagn Res. 2014, 8(8): 4–7

Last updated: Feb 07, 2022 03:25 PM

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