ABSTRACT
Studies
were done to access the health implication of poor hand washing among the
students of Federal College of Agriculture Ishiagu, Ebonyi State, Nigeria. Hand
washing points were stationed around male and female hostel; to wash hands with
and without soap. Some students washed with soap while others washed without
soap. The investigation equally tried to access morning hand washing (8am to 9am)
and afternoon hand washing (2pm to 6pm) to determine microbial level from hands
of the students sampled. A total of one hundred and twenty (120) students
sampled, 60 were males, while 60 were females. Out of the 60 among males, 30
washed with soap, while the other 30 washed without soap. The same procedure
applied to female students. Hand pouring washing method was adopted. With clean
bottled water poured on their hands, the students washed, while the sample
bottles were placed directly below their palms to collect the laboratory for
analysis. The result of the investigation revealed series of bacteria and fungi
isolates, especially on sample collected from hand washing without soap. The
bacteria isolates include staphylococcus
aureus, strptococus pueumonia, eschorichia coli, proteus, salmonella typhi,
kiebsiella, pseudomonas, with staphylococcus
aureus and eschorichia coli having occurrence of 46.67% and 26.67%
respectively for male students, while their occurrence on females was 20.00%
respectively. Fungi isolates implicated in the hand washing were Candida, Aspergillus, Cryptococus,
Histoplasma, Pneumoaystic, Stachyboty, Tinea versicular, Rhizopus, Fuserium and
Penicular, with Candida and
Aspergillus having occurrence of 20% respectively for males and 33.33% and
13.33% respectively for females. However, those that washed with soap had no
microbial contamination. Based on these observations mode, there is need for
provision of hand washing facilities in the school premises and enlighten the
students on the dangers involved in non-hand washing. Soap hand washing should
be encourage among the students because of its anti-microbial action/effect.
CHAPTER ONE
1.0 BACKGROUND OF THE STUDY
1.1 INTRODUCTION
Many students in high institution take hand washing for granted
and do not consider how essential hand washing is in the prevention of
infections and disease. Thus they often fail to wash their hands when they
engage in activity that would warrant or require hand washing. Research has
established that people generally overstate the degree to which they wash their
hands; that female students are much more likely to wash their hands than their
male counterparts and that while hand washing compliance appears to have
increased in recent years much room for growth still exists.
According to the Centers
for Disease Control and Prevention (CDC) (Mead et al., 2015), failing to wash
or insufficiently washing hands contributes to almost
50% of all food borne illness outbreaks. Additionally, Curtis and
Cairncross (2003) performed a meta-analysis that suggests that hand washing
with soap can reduce diarrheal disease risks by more than 40% and that hand
washing interventions could save one million lives annually. Yet we do not know
why people fail to wash their hands at recommended rates and in the proper
fashion. Our research attempted to establish predictors of hand washing that
can be used to induce higher rates of hand washing compliance.
Current Hand Washing Practices Recent surveys establish that U.S.
adults claim to wash their hands after using public restrooms at very high
rates. In 2009, 94% (N =2,516) suggested that they consistently wash
their hands (QSR Magazine, 2009), while in 2010, 96% (N = 1,006) stated
that they always wash their hands after using a public restroom (Harris
Interactive, 2010). Self-reports of hand washing behavior have been criticized
as unreliable as hand washing is a socially desirable activity (Judah, Aunger,
Schmidt, Granger, & Curtis, 2009) and observational research suggests these
high self-report rates are inflated (Harris Interactive, 2010). The potential
discrepancy aside, it is important to note that hand washing rates have trended
upwards in recent years.
The American Society for Microbiology and the American Cleaning
Institute have studied hand washing practices since 1996. Most recently they
reported on hand washing in restrooms at public attractions in five cities
across the U.S.
The restroom locations included Turner Field in Atlanta, the
Museum of Science and Industry and Shedd Aquarium in Chicago, Penn Station and
Grand Central Terminal in New York, and the Ferry Terminal Farmers Market in
San
Francisco (Harris Interactive, 2010). All locations experience
high volumes daily, and at the composite level, the 2010 data (N =
6,028) establishes that 85% of the observed adults wash their hands after using
a public restroom.
This is an increase from 77% in 2007 (N =6,076), which was
somewhat lower than the 2005 rate of 83% (N = 6,336). With the exception
of the Shedd Aquarium, which has seen a 3% dip in hand washing rates since
2005, all the venues saw a slight upward trend in observed hand washing rates
(Harris Interactive, 2010). In 2003, hand washing rates were also observed
across six North American airports, averaging 74% compliance (N =
4,046). The highest hand washing rates were obtained in Toronto with 95% while
Chicago had the lowest rate at 62% (American Society for Microbiology, 2003).
The research consistently finds a gender bias in hand washing
practices. Female students wash their hands more frequently than their male
counterparts. In the 2003 study (American Society for Microbiology) it was
observed that 83% of female students washed their hands after using the
restroom, whereas only 74% of the male students did so.
The high incidence of diarrheal
diseases and other communicable diseases among school Student may be due to
poor knowledge and practice of personal and environmental hygiene (Koopman,
2000; Oduntan, 2004; Hoque, 2003). Poor knowledge and practice of, and
attitudes to personal hygiene, such as hand washing, has negative consequences
for a student’s long term cumulative development (GHWD 1, 2008). Good hand
washing practice is therefore a prerequisite to a student’s survival (UNICEF,
2008; Curtis & Caimcross, 2003). Thus the global sensitization to the
outbreak of the Pandemic Influenza H1N1 in 2009 included hand washing with
clean water and detergent, after critical moments, as a mode of prevention (world News,
2009)
Critical times for hand washing
include after using the toilet, after cleaning a child, and before handling
food (GHWD 1, 2008). For Student in particular, critical moments include after
playing outside, or with toys and pets (Quinn, 2008; Ali, 2008). Although hand
washing with detergent is among the most effective and inexpensive ways to
prevent diarrhoeal diseases and pneumonia, which together are responsible for
the majority of child deaths globally each year, it is seldom practiced and not
always easy to promote, despite its life saving potential (GHWD 1, 2008, GHWD
2, 2008). Studies by Lopez- Quintero et al. (2009) revealed that,
unavailability of detergent and clean towels, is a negative factor to
compliance, and is confirmed by the School Sanitation and Hygiene Education
study (Bolt et al., 2006) in which schools in several developing
countries consistently reported lack of detergent and unavailability of clean
water (Lopez-Quintero et al., 2009).
According to a UNICEF report,
involving Student themselves as active participants in promoting hand washing
with detergent in schools creates in the Student, a sense of ownership that
makes new behaviours more likely to be adhered to (UNICEF, 2008). Therefore,
key hygiene habits such as good hand washing practice that are likely to be
taken further into adulthood can be adopted by encouraging millions of school
Student to engage in these good repetitive, non-reflective behaviours. These
habits can also contribute to the achievement of two of the Millennium Development
Goals (2 and 4), which support Education and Health.
Bennell (2002) argues that since
school Student in developing countries account for up to half of the
population, promotion of these good hygiene and hand washing practice is not
only necessary but also very relevant (Bennell, 2002).
The National Community on Water and Sanitation
Programme has among its mandate to increase the number of school Student, aged
6-15 years, who wash their hands with detergent, especially after using the
toilet (GPPPHW Nigeria, 2005). In addition, the School Health and Education
Programme (SHEP) in Nigeria is to provide comprehensive health education and
services, as well as ensure availability and use of water and sanitation
facilities in schools to facilitate the practice of hand washing. It must be
mentioned, however, that adequate and well-functioning school sanitation and
hand washing facilities play a major role in ensuring good hand washing
practices (Tay, 2005). Although interventions such as the SHEP exist in
schools, studies have not been conducted to assess and document the impact of
these interventions on school Student’s knowledge, attitudes and practices.
In order
to achieve true sustainable development, countries all over the world must
create a world that is fit for Student to live in and that means a world with
safe and adequate water for drinking and hand washing as well as adequate
sanitation. Remarkable improvements have been made in the past century in the
fight against communicable diseases, yet a significant amount of mortality and
morbidity world- wide can still be attributed to these conditions. Respiratory
diseases and diarrhoea are the two leading causes of diseases burden globally
and is responsible half of all child deaths each year. The burden of
communicable disease remains predominantly acute in developing regions such as
Africa and parts of Asia, and Student remain particularly vulnerable. (Ward,
D. 2000).
Recent
estimates in Nigeria indicate that acute respiratory and intestinal infections
are the main cause of mortality among Student under age five, the second
leading cause of death among girls aged 5-14 years, the third leading cause of
infant mortality.
Despite
much evidence supporting the effectiveness of measures such as vaccination,
improvement in sanitary conditions, and basic hygiene practices in controlling
communicable diseases, many developing nations are yet to achieve effective
vaccination coverage and remain plagued with poor sanitary conditions. Basic
personal hygiene behaviours such as hand washing are still not widely
practiced.
Each
year, diarrhoea diseases and acute respiratory infections are responsible for
the deaths of more than 3.5 million Student in the world. Hand washing with detergent and water especially at
critical times-after using the toilet and before handling food helps reduce the
incidence of diarrhoea disease by more than 40%, UNICEF pointed out in 2000
annual report. This is the most effective and in-expensive way to mitigate the
risk of disease, especially bowel diseases like dysentery, hepatitis and
respiratory tract infections diverse health behaviour and social marketing
theories have been applied in the design and implementation of behavioural
change interventions that promote infection – control practices. The theory of
reasoned action and planned behaviour, for example, suggests that a person’s
behaviour is determined by his\her intention to perform the behaviour (Ward,
D. 2000).
Intention,
intern, is a function of the person’s attitudes toward the behaviour, believes
concerning benefits or harms of adopting the behaviour, subjective norms and
normative beliefs, and perceived control over the opportunities, resources, and
skills necessary to perform the behaviour. More
recently, ecological approaches
have been to incorporated into behavioural
theories disentangle independent
effects of individual contextual
factors on health behaviour .The
underlying premise of such models is bidirectional
relation between environmental modifications and
behavioural change.
Bearing
in mind that school Student have been consistently implicated in the spread of
communicable diseases and that matter the school has been recognised as a vital
setting for health promotion.
1.2 STATEMENT OF THE PROBLEM
The
practice of hand washing has remained a problem in federal college of
Agriculture Ishiagu Ebonyi State, especially among the Student. According to
the 2009 annual report from the College Clinic, majority of the Student who
were brought to the clinic in the previous years were diagnosed to be suffering
from diseases associated with inadequate use of water especially in hand washing
with detergent. These diseases include typhoid fever, worm infection and other
diarrhoeal diseases. Thus, these serious health problems need a second look,
since many lost their lives and others exerted an excessive pressure on the
available health facilities.
Hand
washing in Federal college of Agriculture Ishiagu has become a problem because
people seem to feel reluctant in the practice, since according to them, it
consumes time. Others think it is a waste of resources such as detergent and
water. Some people also presume that it must be something routine in human life
in order to promote and protect good health. However, it is obvious that some
people cannot afford detergent and facilities for hand washing are not adequate
and appropriate. In some cases, they are even not available. Sometimes, those
who seem to have little knowledge on appropriate hand washing practices defeat
the purpose of it at the end of the process, by using dirty contaminated
materials to clean them. Little knowledge on or about the critical periods is
also a contributory factor to the problem. Meanwhile, any exercise that induces
hand contamination and others, such as after toilet, attending to a sick
person, handling money, and after visiting refuse disposal sites including hand
shaking is of much interest.
These and others have called for serious attention to the problem, to
reduce the incidence of diarrhoeal related diseases if not a total eradication.
1.3 PURPOSE OF THE STUDY
Many
School Health Education Program SHEP have long supported the WHO recommendation
that standard hand washing with detergent and water is the most effective way
to prevent the spread of infectious illness. The purpose of this study was to
evaluate the effectiveness of regular hand washing for decreasing illness among
Student in Federal college of Agriculture Ishiagu Ebonyi State by reducing specific communicable illnesses
such as colds, flu, and conjunctivitis.
The purpose of the study is to determine the effectiveness of detergent
and clean water in reduction of diseases due to infectious illness.
1.4 JUSTIFICATION
The
practice of hand washing has remained a problem in the study area and has tend
to be a threat to the people in Federal College of Agriculture Ishiagu ,
specifically, the Student and there is a great need to cultivate the habit of
thorough hand washing with detergent and water in people.
1.5 SIGNIFICANCE OF THE STUDY
The research is solely meant to know the effectiveness of regular hand
washing with detergent and warm water in reducing illness among Student. Also,
this study when completed will provide suggestions as to how hand washing can
be improved among Students to reduce infectious disease illness.
1.6 OBJECTIVE OF THE STUDY
1.
To
determine the effectiveness of hand washing as a method of eliminating
infections disease among student of federal college of agriculture Ishiagu.
2.
To
ascertain the rate at which hand washing reduces disease pathogens/parasites
among students of federal college of agriculture Ishiagu.
3.
To
determine the level at which hand washing reduces health problem in the study
area.
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