Personal and domiciliary hygiene practices and its association with incidence of infectious diseases among children aged 6-59 months

Md Hasanuzzaman, Md Hafizur Rahman, Md Shafiqul Islam Khan, Musammet Rasheda Begum, Farjana Alam, Al-Amin Imran


Background: Over 200 million under-five-children born in low-income countries are at risk of not reaching their development potential and infectious diseases are the leading cause of development deficits in these regions.

Methods: A cross-sectional study was conducted to investigate personal and household hygiene practices among 154 mothers and their association with the incidence of infectious diseases among 167 children aged 6 months to 59 months in Patuakhali district, Bangladesh.

Results: Only 13.6% of the mothers had proper hand washing knowledge. Besides, 14% and 53.9% of the mothers washed their hands with soap and only with water respectively before feeding their child. About 68.2% of mothers prepared food on the ground and half (49.5%) of the toilet did not have a hand washing location beside it. The risk of childhood infectious disease was significantly associated with hand washing of mothers before feeding a child (OR: 2.3, 95% CI: 1.5-4.1, p<0.05) and hand washing of child before eating (OR: 3.4, 95% CI: 1.8-5.7, p<0.05).

Conclusions: Hand washing agents were inadequate and compliance to hand washing was poor. Therefore, the continuous focus is needed on the mother's awareness construction to increase the compliance to hand washing practice among mothers as well as their child with soap, especially during child feeding.


Personal hygiene, Domiciliary hygiene, Infectious diseases, Under-5 children

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The global burden of disease. Available at: Accessed on 20 January 2021.

Troeger C, Forouzanfar M, Rao PC. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(9):909-48.

Mokomane M, Kasvosve I, Melo E de, Pernica JM, Goldfarb DM. The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management. Ther Adv Infect Dis. 2018;5(1):29-43.

Diarrhea: Common Illness, Global Killer. Available at: programs/Globaldiarrhea508c.pdf. Accessed on 20 January 2021.

Water, Sanitation and hygiene interventions and the prevention of diarrhoea. Available at: https://www. Accessed on 20 January 2021.

Basic Principles for the preparation of safe food for infants and young children. Available at: https://apps. Accessed on 20 January 2021.

Motarjemi Y, Kaferstein F, Moy G, Quevedo F. Contaminated weaning food: A major risk factor for diarrhoea and associated malnutrition. Bull World Health Organ. 1993;71(1):79-92.

Cairncross S, Bartram J, Cumming O, Brocklehurst C. Hygiene, Sanitation, and Water: What Needs to Be Done? PLoS Med. 2010;7(11):e1000365.

Lu C, Black MM, Richter LM. Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level. Lancet Glob Heal. 2016;4(12):e916-22.

Ngure FM, Reid BM, Humphrey JH, Mbuya MN, Pelto G, Stoltzfus RJ. Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links. Ann NY Acad Sci. 2020:45:83-9.

Stewart CP, Kariger P, Fernald L. Effects of water quality, sanitation, handwashing, and nutritional interventions on child development in rural Kenya (WASH Benefits Kenya): a cluster-randomised controlled trial. Lancet Child Adolesc Heal. 2018; 2(4):269-80.

Fink G, Günther I, Hill K. The effect of water and sanitation on child health: evidence from the demographic and health surveys 1986-2007. Int J Epidemiol. 2011;40(5):1196-204.

Prüss-Üstün A, Bos R, Gore F, Bartram J. Safer water, better health; costs, benefits and sustainability of interventions to protect and promote health. Available at: 10665/43840/9789241596435_eng.pdf?sequence=1&isAllowed=y. Accessed on 20 January 2021.

Bartram J, Cairncross S. Hygiene, sanitation, and water: Forgotten foundations of health. PLoS Med. 2010;7(11):56-9.

Esrey SA, Habicht J-P. Epidemiologic evidence for health benefits from improved water and sanitation in developing countries. Epidemiol Rev. 1986;8(1):117-28.

Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: A systematic review and meta-analysis. Lancet Infect Dis. 2005;5(1):42-52.

Freeman MC, Ogden S, Jacobson J, et al. Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration. PLoS Negl Trop Dis. 2013;7(9):122-9.

Clasen TF, Roberts IG, Rabie T, Schmidt W-P, Cairncross S. Interventions to improve water quality for preventing diarrhoea. In: Cochrane Database of Systematic Reviews. United States: John Wiley & Sons Ltd; 2006.

Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: A systematic review. Lancet Infect Dis. 2003;3(5):275-81.

Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008;(1):45-9.

Luby SP, Agboatwalla M, Feikin DR. Effect of handwashing on child health: A randomised controlled trial. Lancet. 2005;366(9481):225-33.

Rabie T, Curtis V. Handwashing and risk of respiratory infections: A quantitative systematic review. Trop Med Int Heal. 2006;11(3):258-67.

Daniels DL, Cousens SN, Makoae LN, Feachem RG. A case-control study of the impact of improved sanitation on diarrhoea morbidity in Lesotho. Bull World Health Organ. 1990;68(4):455-63.

Doocy S, Burnham G. Point-of-use water treatment and diarrhoea reduction in the emergency context: An effectiveness trial in Liberia. Trop Med Int Heal. 2006;11(10):1542-52.

Black RE, Brown KH, Becker S, Yunus M. Longitudinal studies of infectious diseases and physical growth of children in rural Bangladesh. Am J Epidemiol. 1982;115(3):305-14.

WaterAid Bangladesh, Policy Support Unit. Available at: bangladesh-national-hygiene-baseline-survey-preliminary-report-2014. Accessed on 20 January 2021.

Beumer RR, Kusumaningrum H. Kitchen hygiene in daily life. In: International Biodeterioration and Biodegradation. Netherlands: Elsevier Ltd; 2003:15;299-302.

Hand Hygiene: why, how & when? why?. Available at: Why_How_and_When_Brochure.pdf. Accessed on 20 January 2021.

Niffenegger JP. Proper handwashing promotes wellness in child care. J Pediatr Health Care. 2005; 11(1):26-31.

Handwashing for parents and kids. Paediatr Child Health. 2001;6(1):53-6.

Sanitation and Hygiene promotion: programming guidance. Available at: sanitation_health/hygiene/sanhygpromo.pdf. Accessed on 20 January 2021.

Raw produce selecting and serving it safely. Available at: Accessed on 20 January 2021.

Lehman S. Why nutrients are lost in cut fruits and vegetables. Available at: https://www.verywellfit. com/fruits-vegetables-cut-nutrients-lost-2506106.

Zellmer C, Blakney R, Van Hoof S, Safdar N. Impact of sink location on hand hygiene compliance for Clostridium difficile infection. Am J Infect Control. 2015;43(4):387-9.