Knowledge and Practice of Hand Washing for Intestinal Parasites Control among Students in Selected Secondary Schools in Umuahia South L.G.A., Abia State, Nigeria

Abstract

Background: Intestinal protozoa spread easily through fecal-oral route of contaminated food or water with the infective stages. The high rates of Intestinal parasitic infections reflect the poor hygienic behavior in the society. Climate conditions, inadequate sanitation, economic issues, a lack of access to safe drinking water, poor nutrition, and cultural norms. Handwashing with soap is a critical, cost-effective intervention for preventing infectious diseases, particularly in congregate settings like schools. However, a persistent gap often exists between knowledge and practice, especially in resource-constrained environments. Aim: This study assessed the knowledge, self-reported practices, and environmental determinants of handwashing among secondary school students in Umuahia South Local Government Area, Abia State, Nigeria. Methods: A descriptive cross-sectional study was conducted among 348 students selected via multi-stage sampling from one public and one private secondary school. Data were collected using a structured, pre-tested questionnaire and a facility observation checklist. Analysis involved descriptive statistics, Chi-square tests, independent t-tests, and Spearman’s correlation using SPSS version 25. Results: The study revealed profound knowledge deficits: 79.9% of students incorrectly believed water alone was sufficient for effective handwashing, and only 12.6% knew the recommended 20-second duration. Practice was markedly poor, with 80.7% of students classified as having poor handwashing practice; 55.7% reported not washing hands at all after toilet use. A critical finding was the non-significant, negligible correlation between knowledge scores and practice scores (r = 0.002, p = 0.967). The leading barrier to practice was the unavailability of soap (34.8%). Direct observation confirmed a stark disparity in facilities, with the private school having superior, functional infrastructure compared to the basic, container-dependent system in the public school. Conclusion and Recommendations: The study concludes that a severe knowledge-practice gap exists, driven more by material constraints and weak social norms than by knowledge alone. To bridge this gap, integrated, multi-level interventions are recommended. These include integrating practical hand hygiene education into the school curriculum, enforcing minimum standards for consistent soap and water provision in all schools, and implementing strategies to build positive social norms through role-modelling and peer-led initiatives.