FACTORS LEADING TO LACK OF PRACTISE OF WASHING HANDS AFTER VISITING TOILET

Lack of practice of washing hands, after visiting toilet is a serious problem, predisposing the community to a greater number of infections. This leads to increase in burden of hospitals both in Public and Private sector.Objectives: To identify various factors leading to lack of washing of hands after visiting toilet, make suggestions to solve the problems and aware the community regarding importance of washing hands after visiting a toilet.Study Design: Population based case-control studyPlace and Duration: In Urban population of Lahore from June 2012 to September 2012.Subjects and methods: A population based case-control study with 1:1 case to control ratio was conducted. A total of 100 persons (50 cases and 50 controls) were recruited in the study. Selection was made on laid down criteria from people living in Urban Lahore after taking due consent .Interviews were conducted through a pretested questionnaire  by a team of 8 members (batch 6), 4^th year MBBS students of King Edward Medical University, Lahore, under direct supervision of Department of Community Medicine, KEMU. Data was collected, compiled and analyzed through SPSS version 20.Results: Of total people investigated 42% were males and 58% were females. Lack of washing hands after visiting toilet was found more in males (60%) and lesser in females (40%) , more in children (60% of total children investigated were cases) and old age individuals (56% of total old age individuals investigated were cases).48 % of total investigated students, office workers, educated house wives lacked the habit of washing hands after visiting toilet while lack of washing hands after using toilet was found in 60% of laborers, maids, gardeners, sweepers  and others with low socioeconomic status involved in survey. In bivariate analysis, lack of washing hands was found significantly associated with poverty (OR:0.202, 95%CI: 0.053-0.768), hypochondria (OR: 0.534, 95%CI: 0.146-1.954), lack of public toilets (OR:0.510, 95%CI: 0.226-1.149),  lack of health education ( OR: 0.182, 95%CI: 0.048-0.685), illness (OR: 0.516, 95%CI:0.184-1.443) ,literacy (OR:0.396, 95%CI: 0.113-1.384) ,anxiety (OR: 0.780, 95%Cl: 0.351-1.734) or hurried nature (OR: 0.286, 95%Cl: 0.094-0.868) etc. However in multivariate analysis while controlling all other risk factors, lack of health education

(OR: 0.182, 95%CI: 0.048-0.685), poverty (OR: 0.202, 95%CI: 0.053-0.768) and hurried nature (OR: 1.157, 95%CI:0.095-14.048) were found significantly associated with the lack of washing hands after using toilet.

Conclusion: Lack of washing hands after using toilet was found significantly associated with health education, poverty and hurried nature.

Key words: Lack of washing hands, poverty, health education, factors, illness, nocturia, hygiene, water supply, toilet facilities.