Yumiko Otsuka1, Lina Agestika1, Hidenori Harada2, Lies Sriwuryandari3, Neni Sintawardani3, Taro Yamauchi1,4. 1. Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan. 2. Graduate School of Global Environmental Studies, Kyoto University, Kyoto, Japan. 3. Research Unit for Clean Technology (LPTB), Indonesian Institute of Sciences (LIPI), Bandung, Indonesia. 4. Research Institute for Humanity and Nature, Kyoto, Japan.
Abstract
OBJECTIVE: Globally, the challenge of handwashing with soap (HWWS) still exists despite the importance of HWWS being shown previously. This study aimed to evaluate faecal contamination on the hands of children and to find factors related to faecal contamination from handwashing techniques, HWWS, knowledge and awareness of water, sanitation, and hygiene (WASH), and a comprehensive WASH index. METHODS: The study was conducted at two elementary schools with 169 children in a densely populated area of Bandung, Indonesia. The survey involved handwashing observation using a checklist, hand bacteria sampling and questionnaires. RESULTS: Most children (98.7%) had faecal contamination. Girls had significantly fewer Escherichia coli than boys (P < 0.05). Ability in handwashing techniques, HWWS, and knowledge and awareness of WASH were poor in the lower grades. Escherichia coli counts were negatively correlated with handwashing technique (r = -0.171, P < 0.05), HWWS (r = -0.225, P < 0.01) and the WASH index (r = -0.205, P < 0.05). CONCLUSIONS: Proper handwashing technique and HWWS at appropriate times can reduce faecal contamination. Moreover, it is important that both grade-based and gender-based handwashing education be considered in elementary school education.
OBJECTIVE: Globally, the challenge of handwashing with soap (HWWS) still exists despite the importance of HWWS being shown previously. This study aimed to evaluate faecal contamination on the hands of children and to find factors related to faecal contamination from handwashing techniques, HWWS, knowledge and awareness of water, sanitation, and hygiene (WASH), and a comprehensive WASH index. METHODS: The study was conducted at two elementary schools with 169 children in a densely populated area of Bandung, Indonesia. The survey involved handwashing observation using a checklist, hand bacteria sampling and questionnaires. RESULTS: Most children (98.7%) had faecal contamination. Girls had significantly fewer Escherichia coli than boys (P < 0.05). Ability in handwashing techniques, HWWS, and knowledge and awareness of WASH were poor in the lower grades. Escherichia coli counts were negatively correlated with handwashing technique (r = -0.171, P < 0.05), HWWS (r = -0.225, P < 0.01) and the WASH index (r = -0.205, P < 0.05). CONCLUSIONS: Proper handwashing technique and HWWS at appropriate times can reduce faecal contamination. Moreover, it is important that both grade-based and gender-based handwashing education be considered in elementary school education.