Enkhbat Munguntuul, Togoobaatar Ganchimeg, Erdenee Oyunchimeg, Takekuma Katsumata Asako
Department of Public Health Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
Department of Global Health Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Front Public Health. 2025 Jun 12;13:1570178. doi: 10.3389/fpubh.2025.1570178. eCollection 2025.
The coronavirus disease 2019 (COVID-19) pandemic has highlighted the critical importance of handwashing as a preventive measure against the spread of SARS- CoV-2. This study aimed to assess changes in handwashing knowledge, attitudes, and practices (KAP) among primary schoolchildren in Ulaanbaatar, Mongolia, before and during the pandemic.
A longitudinal study was conducted with 399 children aged 8-11 years, with data collected in December 2019 (pre-pandemic) and January 2021 (during the pandemic). A self-reported questionnaire was used to assess the children's handwashing KAP, focusing on four critical moments for handwashing: after using the toilet, before eating, after touching visibly dirty or unhygienic things, and after coming home.
The results showed a significant increase in handwashing knowledge and attitudes during the pandemic, with the average knowledge score rising from 9.8 to 12.3 and the percentage of correct responses about critical handwashing moments increasing from 23.0 to 80.4%. Handwashing practices also improved, with an increased frequency of handwashing at critical moments, although practice before eating remained unchanged. Sociodemographic factors, such as sex, grade level, and parental education, were associated with handwashing behaviors. Girls were significantly more likely to engage in proper handwashing (AOR = 4.50, < 0.01), while fourth-grade students showed higher odds of practicing proper handwashing than third-grade students (AOR = 5.27, < 0.01). Fathers' higher education and maternal self-employment were positively associated with proper handwashing, whereas fathers' employment in public service was negatively associated. The overall KAP scores showed a significant increase during the pandemic, with a mean difference of 3.68 [95% CI = (4.06, 3.29), < 0.01], indicating a notable improvement in handwashing behavior.
These findings highlight the importance of health education and interventions in shaping children's hygiene behaviors during global health crises, with lasting implications for public health strategies, particularly in resource-limited settings.
2019年冠状病毒病（COVID-19）大流行凸显了洗手作为预防严重急性呼吸综合征冠状病毒2（SARS-CoV-2）传播的预防措施的至关重要性。本研究旨在评估蒙古国乌兰巴托市小学生在大流行之前和期间洗手知识、态度和行为（KAP）的变化。
对399名8至11岁的儿童进行了一项纵向研究，于2019年12月（大流行前）和2021年1月（大流行期间）收集数据。使用一份自我报告问卷来评估儿童的洗手KAP，重点关注四个洗手关键时刻：上完厕所后、吃饭前、接触明显脏污或不卫生的东西后以及回家后。
结果显示，在大流行期间，洗手知识和态度有显著增加，平均知识得分从9.8提高到12.3，关于关键洗手时刻的正确回答百分比从23.0%增加到80.4%。洗手行为也有所改善，关键时刻洗手频率增加，尽管吃饭前的行为没有变化。社会人口学因素，如性别、年级和父母教育程度，与洗手行为有关。女孩进行正确洗手的可能性显著更高（比值比[AOR]=4.50，P<0.01），而四年级学生进行正确洗手的几率高于三年级学生（AOR=5.27，P<0.01）。父亲的高学历和母亲的自营职业与正确洗手呈正相关，而父亲在公共服务部门工作则呈负相关。总体KAP得分在大流行期间显著增加，平均差异为3.68[95%置信区间（CI）=(4.06,3.29)，P<0.01]，表明洗手行为有显著改善。
这些发现凸显了健康教育和干预措施在全球健康危机期间塑造儿童卫生行为方面的重要性，对公共卫生策略具有持久影响，特别是在资源有限的环境中。
