Epidemiological investigation on hand hygiene knowledge and behaviour: a cross-sectional study on gender disparity

BMC Public Health. 2019 Apr 11;19(1):401. doi: 10.1186/s12889-019-6705-5.


Background: The hand hygiene (HH) behaviour of the general public and its effect on illnesses are issues of growing importance. Gender is associated with HH behaviour. HH efficiency is a combination of washing efficiency and hand drying, but information about the knowledge level and HH behaviour of the general public is relatively limited. The findings of this cross-sectional study can substantially contribute to the understanding on the knowledge gap and public behaviour towards HH, thereby providing information on gender-specific health promotion activities and campaigns to improve HH compliance.

Methods: An epidemiological investigation by using a cross-sectional study design on the general public was conducted either via an online platform (SurveyMonkey) or paper-and-pen methods. The hand-washing and -drying questionnaire was used for data collection.

Results: A total of 815 valid questionnaires were collected. Majority of the respondents can differentiate the diseases that can or cannot be transmitted with poor HH, but the HH knowledge of the respondents was relatively inadequate. The female respondents had a significantly better HH knowledge than male respondents. The multiple regression analysis results also indicated that females had a significantly higher knowledge score by 0.288 towards HH than males after adjusting for age and education level. Although the majority of the respondents indicated that they performed hand cleaning under different specific situations, they admitted only using water instead of washing their hands with soap. More males than females dried their hands on their own clothing, whereas more females dried their hands through air evaporation. The average time of using warm hand dryers was generally inadequate amongst the respondents.

Conclusions: Being a female, middle-aged and having tertiary education level are protective factors to improve HH knowledge. Misconceptions related to the concepts associated with HH were noted amongst the public. Self-reported practice on hand drying methods indicated that additional education was needed. The findings of this study can provide information on gender-specific health promotion activities and creative campaigns to achieve sustained improvement in HH practices.

Keywords: Cross sectional study; Gender; Hand drying; Hand hygiene; Hand washing; Knowledge; Public; Survey; Washrooms.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Hand Disinfection*
  • Hand Hygiene / statistics & numerical data*
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Health Promotion / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Self Report
  • Sex Factors
  • Surveys and Questionnaires
  • Young Adult