Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2022 Oct 27;22(1):1969. doi: 10.1186/s12889-022-14390-4.
Handwashing is fundamentally an inexpensive means of reducing the spread of communicable diseases. In developing countries, many people die due to infectious diseases that could be prevented by proper hand hygiene. The recent coronavirus (COVID-19) pandemic is a threat to people who are living in resource-limited countries including sub-Saharan Africa (SSA). Effective hand hygiene requires sufficient water from reliable sources, preferably accessible on premises, and access to handwashing facility (water and or soap) that enable hygiene behaviors. Therefore, this study aims to determine the prevalence of limited handwashing facility and its associated factors in sub-Saharan Africa.
Data from the Demographic and Health Surveys (DHS) were used, which have been conducted in 29 sub-Saharan African countries since January 1, 2010. A two-stage stratified random cluster sampling strategy was used to collect the data. This study comprised a total of 237,983 weighted samples. The mixed effect logistic regression model with a cluster-level random intercept was fitted. Meta-analysis and sub-group analysis were performed to establish the pooled prevalence.
The pooled prevalence of limited handwashing facility was found to be 66.16% (95% CI; 59.67%-72.65%). Based on the final model, household head with age group between 35 and 60 [AOR = 0.89, 95% CI; 0.86-0.91], households with mobile type of hand washing facility [AOR = 1.73, 95% CI; 1.70-1.77], unimproved sanitation facility [AOR = 1.58, 95% CI; 1.55-1.62], water access more than 30 min round trip [AOR = 1.16, 95% CI; 1.13-1.19], urban residential area [AOR = 2.08, 95% CI; 2.04-2.13], low media exposure [AOR = 1.47, 95% CI; 1.31-1.66], low educational level [AOR = 1.30, 95% CI; 1.14-1.48], low income level [AOR = 2.41, 95% CI; 2.33-2.49] as well as lower middle-income level [AOR = 2.10, 95% CI; 2.14-2.17] and households who had more than three children [AOR = 1.25, 95% CI; 1.20-1.31] were associated with having limited handwashing facility.
The pooled coverage of limited handwashing facility was high in sub-Saharan Africa. Raising awareness of the community and promoting access to handwashing materials particularly in poorer and rural areas will reduce its coverage.
洗手是一种基本的、廉价的传染病传播控制方法。在发展中国家，许多人死于本可通过正确的手部卫生来预防的传染病。最近的冠状病毒（COVID-19）大流行对包括撒哈拉以南非洲（SSA）在内的资源有限国家的人民构成了威胁。有效的手部卫生需要来自可靠来源的充足用水，最好在场所内提供，并且需要有洗手设施（水和/或肥皂）来实现卫生行为。因此，本研究旨在确定撒哈拉以南非洲地区有限的洗手设施的流行情况及其相关因素。
本研究使用了 2010 年 1 月 1 日以来在撒哈拉以南非洲的 29 个国家进行的人口与健康调查（DHS）的数据。采用两阶段分层随机聚类抽样策略收集数据。本研究共包含 237983 个加权样本。采用具有聚类水平随机截距的混合效应逻辑回归模型进行拟合。进行荟萃分析和亚组分析以确定汇总的流行率。
发现撒哈拉以南非洲地区有限的洗手设施的流行率为 66.16%（95%CI;59.67%-72.65%）。根据最终模型，年龄组在 35 至 60 岁之间的家庭户主[比值比（AOR）=0.89，95%置信区间（CI）;0.86-0.91]、具有移动型洗手设施的家庭[AOR=1.73，95%CI;1.70-1.77]、卫生设施未得到改善[AOR=1.58，95%CI;1.55-1.62]、取水往返超过 30 分钟[AOR=1.16，95%CI;1.13-1.19]、居住在城市地区[AOR=2.08，95%CI;2.04-2.13]、媒体接触度低[AOR=1.47，95%CI;1.31-1.66]、教育水平低[AOR=1.30，95%CI;1.14-1.48]、收入水平低[AOR=2.41，95%CI;2.33-2.49]以及中下收入水平[AOR=2.10，95%CI;2.14-2.17]以及有三个以上孩子的家庭[AOR=1.25，95%CI;1.20-1.31]与有限的洗手设施有关。
撒哈拉以南非洲地区有限的洗手设施覆盖率很高。提高社区的认识并促进洗手材料的获取，特别是在较贫穷和农村地区，将降低其覆盖率。
