Hand hygiene habits of children and adolescents of Leiria Muriel Ferreira, Patrícia Miranda, Fernanda Pedrosa, Alexandra Luz, Pascoal Moleiro

Introduction and aims  Hands are an important form by which germs are transmitted between people.  Performing correct hand washing is the main procedure to control infections.  The aim of this study was to characterize the habits of hand hygiene in a school population of Leiria.

 Descriptive cross-sectional study with prospective data collection.  Study population: children and adolescents from basic to high school (Escola Dr. Correia Mateus)  A survey was applied, which comprised 11 items that assessed hands hygiene habits.  We obtained prior informed consent from parents.  Subdivision in two age groups: group 1 (8-12 years) and group 2 (13-17 years).  Data analysis in SPSS  v 22.0 (α=0,05). Material and Methods

 534 surveys  Average age of children and adolescents: 11.9Y ( 8 – 17Y)  50% ♂ Results NR

Results  26.2% of children and adolescents reported “I always wash my hands”  Washing takes less than 1 minute in 57.7% of the cases. Reasons for not washing hands (n=391)% Forgetfulness75.4% No soap33.5% Is is a waste of time12.8% Lack of routine11.8% Other reasons8.2% Lack of supervision4.1% Amount of liquid soap% Less than 1mL5.8% 1mL15.7% More than 1mL15.5% Not aware62.2%

Results “I wash my hands...."NeverFew times Some times Most of the times Always After going to the bathroom?0.9%3.6%13.1%25.8%56.1% Before meals?2.1%6.7%25.0%32.7%32.5% Before touching food?1.7%6.2%15.5%30.7%45% After cleaning the house?9.5%8.2%13.8%18.9%45.4% After touching animals (even pets)?4.9%5.2%9%20.2%60.2% After coughing, sneezing or blowing my nose? 9.2%16.1%26%32.1%14.8% After visiting someone sick?7.7%11.6%16.3%22.1%39.6% After outdoor activities (egº garden or park)?6.7%7.9%19.3%27.7%37.8%

Results “I always use..."% Liquid soap53.3% Bar soap19.6% Dishwashing products4.3% Laundry products1.3% Other products2.1% I don’t use anything to wash my hands3.9% “I dry my hands always using..."% Towel53.6% Disposable paper tissues15% Kleenex5.8% Toilet paper5.4% Automatic dryer4.1% I don’t use anything3.9% Clothes2.6%

Results “I wash my hands always..."Group 1Group 2p After going to the bathroom?47.8%66.9%<0.001 Before meals?35.8%28.1%0.123 Before touching food?49.3%40.3%0.120 After cleaning the house?47.8%78.3%0.310 After touching animals (even pets)?62.1%56.5%0.117 After coughing, sneezing or blowing my nose?17.2%11.8%0.122 After visiting someone sick?47.4%29.4%<0.001 After an outdoor activities (eg º garden or park)?8.9%3.8%0.018

Results “It is very important to have..." ♀♂ p A good hand hygiene67.4%51.1%<0.001 Training in this area57.7%48.1%0.015 "It is very important to have..."Group 1Group 2p A good hand hygiene64.8%44.8%0.011 Training in this area58%52.9%0.022

 A quarter of the population always washes their hands  Half of the population uses liquid soap for washing and a towel for drying hands.  After going to the bathroom, the older group washes their hands more often.  Washing hands after visiting someone sick or having an outdoor activity was more frequent in the younger group.  The younger and female groups aknowledge more importance to hand hygiene and training in this area. Summary of results

 Global hand washing remains a goal to achieve.  Children, younger adolescents and females report higher importance to this procedure and training in this area.  Training sessions on hand washing are scheduled in schools, as well as evaluation of their impact on children and adolescents. Conclusions