Ly Anh N, Craig Christina, McDavid Kelsey, Maheia Dian, Gongora Yolanda, Morey Francis, Manzanero Russell, Medley Alexandra, Stewart Allison, Lino Allison, Quezada Ramiro, Blanco Rosalva, Romero Vickie, Morazan Gerhaldine, Hawes Ella, Okeremi Oluwadara, Ishida Kanako, Lozier Matthew, Murray Kristy O
Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Trop Med Hyg. 2025 May 27;113(2):427-436. doi: 10.4269/ajtmh.24-0617. Print 2025 Aug 6.
Hand hygiene (HH) can prevent the spread of infectious diseases and school absenteeism. However, limited data exist on HH practices at schools. Our study assesses the impact of a pilot HH intervention in 12 schools in Belize during the coronavirus disease 2019 (COVID-19) pandemic. After a national assessment of existing water, sanitation, and hygiene resources (December 2021-January 2022), 12 pilot schools were selected to evaluate an HH intervention, which included environmental nudges and HH education. Baseline assessments occurred in March 2022, the HH intervention was implemented during October 2022-May 2023, and follow-up assessments were conducted in June 2023. Student knowledge, attitudes, practices (KAP), and hand dirtiness were assessed at baseline and follow-up. There were no changes in overall KAP median scores between the baseline and the follow-up surveys (knowledge: 3 of 4; attitudes: 11 of 12; practices: 8 of 8). There was an increase in the proportion of students who reported cleaning hands during critical moments, such as before eating and after using the restroom. Observations showed that 83% of students at baseline and 71% of students at follow-up washed their hands with soap after using the restroom. The median hand dirtiness score was seven at baseline and five at follow-up (lower score corresponds to dirtier hands). We did not observe improvements in HH after the intervention. It is possible that the decrease in perceived risk of infection as COVID-19 protocols from baseline to follow-up were reduced in schools contributed to the decrease in HH practices.
手部卫生（HH）可以预防传染病的传播和学生缺勤。然而，关于学校手部卫生实践的数据有限。我们的研究评估了在2019年冠状病毒病（COVID-19）大流行期间，在伯利兹的12所学校开展的手部卫生试点干预措施的影响。在对现有的水、环境卫生和个人卫生资源进行全国评估（2021年12月至2022年1月）之后，选择了12所试点学校来评估一项手部卫生干预措施，其中包括环境提示和手部卫生教育。基线评估于2022年3月进行，手部卫生干预措施于2022年10月至2023年5月实施，后续评估于2023年6月进行。在基线和随访时评估了学生的知识、态度、实践（KAP）以及手部脏污情况。在基线调查和随访调查之间，总体KAP中位数得分没有变化（知识：4项中的3项；态度：12项中的11项；实践：8项中的8项）。在关键时刻（如吃饭前和使用卫生间后）报告洗手的学生比例有所增加。观察表明，基线时83%的学生和随访时71%的学生在使用卫生间后用肥皂洗手。手部脏污中位数得分在基线时为7分，随访时为5分（得分越低表示手部越脏）。我们在干预后未观察到手部卫生的改善。从基线到随访，学校中COVID-19防控措施导致的感染风险感知降低，这可能导致了手部卫生实践的减少。
