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Fulltext Perceptions and barriers of hands hygiene practice among medical science students in a medical school in Malaysia

R.A. Al-Naggar, Al-Jashamy, K.

International Medical Journal Malaysia, 2013;12(2):11-14.
MyJurnal

Hand hygiene is the single, most critical measure for reducing the risk of transmitting organisms to patients and health care providers. To our knowledge, none of such study on Malaysian university student exists in the literature. Therefore, the objective was to explore the perceptions and barriers of hand's hygiene practice among university students. Methods: Focus group discussion conducted in January-2010 among 40 medical science students from Management and Science University (MSU). Simple random sampling was used, and the ethics were obtained from participants. The students were divided into five focus groups; the number of each group ranged between 8-10 members. The data obtained were classified into various categories, and the data was analyzed manually. Results: The majority of the participants mentioned that they frequently washed their hands using soap. Some of the participants washed the hands only with plain water. However, the majority of the participants mentioned that the laziness was their main barrier of frequent hand washing, followed by lack of nearby water supply and then the feeling that their hands are not dirty enough to be infected. The majority of the participants agreed that hand washing is clinically significant in reducing the spread of infectious diseases; some of them disagreed. The Majority of the participants knew the hand washing technique in the university. Conclusion: Medical science students still have some misconception and negative attitude towards hand hygiene practice. Multidisciplinary strategies needed to improve hand hygiene among students.

Matched MeSH terms: Hand Disinfection
Plasma cholinesterase screening

Goh CS

Family Practitioner, 1986;9:40-42.

The plasma cholinesterase baseline levels in Malaysian workers are within the guidelines used. There is a need to carry out close monitoring of workers handling organophosphate s even in a well-run, modern factory where there are no hazards in the plant operation. Abnormal results are mainly because many of our workers are unaware of the health hazards and do not follow orders properly, ie personal hygiene, such as washing of hands before eating, etc. The use of temporary workers should be discouraged because of poor compliance with rules and difficulty in follow up. Product stewardship and education of farmers, sprayers and end users are of paramount importance. Finally there is a great need for educaiton of everyone from factory workers, farmers, sprayers to the general public.

Matched MeSH terms: Hand Disinfection
Risk factors associated with soil transmitted helminth (STH) infection in two indigenous communities in Malaysia

Nisha M, Aiman M, Asyhira N, Syafiq H, Atiqah N, Kumarasamy V, et al.

Trop Biomed, 2020 Jun 01;37(2):379-388.
PMID: 33612807

Soil-transmitted helminth (STH) could possibly cause mild to severe health effects such as diarrhea, weakness, intestinal blood loss, and impaired cognitive development and growth. In Malaysia, previous studies depicted a high prevalence rate of STH was due to poor hygiene practice and low efficacies of anthelminthic drugs. This study was conducted to investigate hand hygiene practice and WASH criteria's (Water, sanitation and hygiene) related to STH infection among two indigenous tribes in Peninsular Malaysia. A cross-sectional study was carried out to study the relationship among STH infection compared to water quality, sanitation, and hygiene conditions. A total of 190 individuals from two indigenous villages participated in the study, with ages ranging from 5 to 60 years old. In addition, Pearson's Chisquare (X2) test was utilized to test the relationship among STH with demographic socioeconomic and behavioral factors. The confidence interval (CI) of 95% is used to estimate the precision of the odds ratio (OR). Multivariate logistic regression models were also used to identify the risk factors associated with STH infections. The overall findings indicated a prevalence rate of 72% for STH, and distributed mainly among children aged < 12 years. Furthermore, multivariate analyses using logistic regression revealed chronic health problems, incorrect hand washing, and walking bare footed were associated with STH infection. Overall results indicated high prevalence of STH among the indigenous villagers, which aligns with the published literature and proves to be a problem need to be addressed as neglected disease. Interestingly, there was a significant relationship between the presences of chronic diseases and STH infection, which prompted other questions the awareness needs to be educated and the simple and low-cost intervention on the proper way of hand washing may help to reduce STH infection in these indigenous communities.

Matched MeSH terms: Hand Disinfection
Fulltext Social media use as a predictor of handwashing during a pandemic: evidence from COVID-19 in Malaysia

Zhang SX, Graf-Vlachy L, Looi KH, Su R, Li J

Epidemiol Infect, 2020 10 23;148:e261.
PMID: 33092675 DOI: 10.1017/S0950268820002575

Although handwashing is an effective way to prevent infections, there is scarce evidence on predictors of handwashing during a pandemic. This paper aims to identify behavioural and demographic predictors of handwashing. The study surveyed 674 adults in Malaysia in May 2020 regarding whether the time spent on social media predicted handwashing contingent on gender and number of children. More time spent on social media was positively associated with handwashing for males with three or more children. However, for males without children, social media use was negatively associated with handwashing. The association was not significant for males with one or two children. For females, more time spent on social media was significantly linked to more handwashing only for females with one child. Gender, a traditional predictor of handwashing, was a useful predictor only for those who spent more than three hours per day on social media and had at most one child. Number of children was a novel negative predictor for males who did not use social media and who averaged one hour per day on social media, a positive predictor for males who spent lots of time on social media, but not a predictor for females. In sum, social media use predicts handwashing, and is thus a helpful variable for use in targeted health communication during a pandemic - particularly through social media. Further, more conventional predictors like gender and number of children exhibit contingency effects with social media use.

Matched MeSH terms: Hand Disinfection*
Fulltext Supplementing hand washing with proper use of alcoholic hand rub in a special neonatal care unit in a large academic public health institute at Jabalpur, Madhya Pradesh, India

Singh M, Agrawal A, Sisodia D, Kasar PK, Kaur A, Datta V, et al.

BMJ Open Qual, 2021 11;10(4).
PMID: 34759034 DOI: 10.1136/bmjoq-2020-001131

OBJECTIVE: The purpose was to increase use of alcoholic hand rub (AHR) in specialised newborn care unit (SNCU) to improve hand hygiene in order to reduce neonatal sepsis and mortality at Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur.
DESIGN: A prospective interventional and observational study.
METHODOLOGY: We formed a quality improvement (QI) team in our SNCU consisting of doctors, nurses, auxiliary staff and parents (a floating member) to improve proper use of AHR. To identify the barriers to the problem, we used fishbone analysis tool. The barriers which were not allowing the health providers to use AHR properly identified were amount of AHR in millilitres to be used per day per baby, how much and when the amount of AHR to be indented from the main store and what is the proper site to place the bottle. We used plan-do-study-act cycles to test and adapt solutions to these problems. Within 5-6 weeks of starting our project, AHR use increased from 44 mL to 92 mL per baby per day and this is sustained around 100 mL per baby per day for over 2 years now.
RESULTS: Significant decrease in neonatal mortality was observed (reduced from median of 41.0 between August 2016 and April 2018 to 24.0 between May 2018 and December 2019). The neonates discharged alive improved from 41.2 to 52.3 as a median percentage value. The percentage of babies who were referred out and went Left Against Medical Advice (LAMA) deceased too.
CONCLUSION: Multiple factors can lead to neonatal deaths, but the important factors are always contextual to facilities. QI methodology provides health workers with the skills to identify the major factors contributing to mortality and develop strategies to deal with them. Improving processes of care can lead to improved hand hygiene and saves lives.

Matched MeSH terms: Hand Disinfection*
The effect of food safety education on handwashing practices in school canteens’ food handlers

Nik Rosmawati N, Wan Manan W, Noor Izani N, Nik Nurain N, Razlina A

Sains Malaysiana, 2018;47:2119-2128.

This study aims to assess the effectiveness of a newly developed food safety education to improve the handwashing
practices of food handlers in school canteens. A community-based intervention study was carried out over a 2-year period.
Sixteen out of 98 primary schools were randomly selected and assigned into intervention and control groups using a
simple random sampling method. The study population included food handlers who worked in the canteens of the school
selected. The Food Safety Education Programme (FSEP) for the intervention group was developed based on the theory of
planned behaviour. The main outcome measures used were handwashing practices from the observations carried out at
baseline, 6-weeks (Post1) and 12-weeks (Post2) after the intervention. Out of 79 food handlers who participated in this
study, 33 (41.8%) were in the intervention group and 46 (58.2%) were in the control group. Prior to FSEP, handwashing
was not commonly practiced following critical events and the majority did not perform correctly. The time-effect of the
mixed design analysis of variance showed a significant increase (p=0.004) in the mean percentage of the total observed
handwashing practices from 29% at the baseline to 50.8% at Post1 (p=0.004). However, the intervention-effect of mixed
design ANOVA did not show any significant difference in the handwashing practices (p=0.210). The FSEP was effective in
improving the handwashing practices of the food handlers in the selected primary school canteens.

Matched MeSH terms: Hand Disinfection
Fulltext The lack of effective hand washing practice despite high level of knowledge and awareness in medical students of clinical years

S. Sulaiha S.A., Wee, Yun Ling, Lie, Joo Chin, Eow, Wei-Liang, Muhamad Faiz, S., Chien, Noris Fook Tan

International e-Journal of Science, Medicine & Education, 2010;4(2):-.
MyJurnal

Background: Nosocomial infection is among the leading problem in many major hospitals resulting in soaring cost expenditure in managing its affect.Hand washing practice is a crucial preventive way to contain such mischief but many ignored its importance. This is perhaps due to lack of appropriate role modeling from senior practitioners.
Subjects and methods: Our study examined the prevalence of hand washing practice among medical students from year 3 to 5 and compared it to their knowledge and level of awareness on its importance in clinical practice. 142 students were randomly observed during their clinical work in the wards on this practice and questionnaires were later distributed to 268 students from all semesters on their knowledge on the technique and awareness on its importance.
Results: Out of 142, almost 80% washed their hands but only 41.6% performed effective hand washing. In contrary, 80 to 90% showed good level of knowledge and awareness as well as perception about its importance in clinical practice.
Conclusions: The contradictory findings between the actual practice of hand washing and knowledge as well as awareness suggest that enforcement on the practice is necessary. This requires motivation and cooperation from all health alliances and higher authority in the health system. Remedial measures are much needed in order to contain high incidence of nosocomial infection in our local practice.

Matched MeSH terms: Hand Disinfection
Fulltext The prevalence and preventive measures of the respiratory illness among Malaysian pilgrims in 2013 Hajj season

Hashim S, Ayub ZN, Mohamed Z, Hasan H, Harun A, Ismail N, et al.

J Travel Med, 2016 Feb;23(2):tav019.
PMID: 26858268 DOI: 10.1093/jtm/tav019

BACKGROUND: Respiratory illness continues to exert a burden on hajj pilgrims in Makkah. The purpose of this study is to determine the prevalence of respiratory illness and its associated factors among Malaysian hajj pilgrims in 2013 and to describe its preventive measures.
METHODS: A cross-sectional study was conducted in Makkah and Malaysia during the 2013 hajj season. A self-administered proforma on social demographics, previous experience of hajj or umrah, smoking habits, co-morbid illness and practices of preventive measures against respiratory illness were obtained.
RESULTS: A total of 468 proforma were analysed. The prevalence of the respiratory illness was 93.4% with a subset of 78.2% fulfilled the criteria for influenza-like illness (ILI). Most of them (77.8%) had a respiratory illness of <2 weeks duration. Approximately 61.8% were administered antibiotics but only 2.1% of them had been hospitalized. Most of them acquired the infection after a brief stay at Arafat (81.2%). Vaccination coverages for influenza virus and pneumococcal disease were quite high, 65.2% and 59.4%, respectively. For other preventive measures practices, only 31.8% of them practiced good hand hygiene, ∼82.9% of pilgrims used surgical face masks, N95 face masks, dry towels, wet towels or veils as their face masks. Nearly one-half of the respondents (44.4%) took vitamins as their food supplement. Malaysian hajj pilgrims with previous experience of hajj (OR 0.24; 95% CI 0.10-0.56) or umrah (OR 0.19; 95% CI 0.07-0.52) and those who have practiced good hand hygiene (OR 0.35; 95% CI 0.16-0.79) were found to be significantly associated with lower risk of having respiratory illness. Otherwise, pilgrims who had contact with those with respiratory illness (OR 2.61; 95% CI 1.12-6.09) was associated with higher risk.
CONCLUSIONS: The prevalence of respiratory illness remains high among Malaysian hajj pilgrims despite having some practices of preventive measures. All preventive measures which include hand hygiene, wearing face masks and influenza vaccination must be practiced together as bundle of care to reduce respiratory illness effectively.

Matched MeSH terms: Hand Disinfection
Fulltext The trajectory of COVID-19 pandemic and handwashing adherence: findings from 14 countries

Szczuka Z, Abraham C, Baban A, Brooks S, Cipolletta S, Danso E, et al.

BMC Public Health, 2021 10 05;21(1):1791.
PMID: 34610808 DOI: 10.1186/s12889-021-11822-5

BACKGROUND: The COVID-19 pandemic has affected people's engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study investigated whether adherence to the World Health Organization's (WHO) handwashing guidelines (the outcome variable) was associated with the trajectory of the COVID-19 pandemic, as measured by the following 6 indicators: (i) the number of new cases of COVID-19 morbidity/mortality (a country-level mean calculated for the 14 days prior to data collection), (ii) total cases of COVID-19 morbidity/mortality accumulated since the onset of the pandemic, and (iii) changes in recent cases of COVID-19 morbidity/mortality (a difference between country-level COVID-19 morbidity/mortality in the previous 14 days compared to cases recorded 14-28 days earlier).
METHODS: The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March-July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports.
RESULTS: Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = -.041, SE = .013, p = .013) and mortality (B = -.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants' COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14-20% of the variance in handwashing adherence.
CONCLUSIONS: To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic.
TRIAL REGISTRATION: Clinical Trials.Gov, # NCT04367337.

Matched MeSH terms: Hand Disinfection