Knowledge and attitudes of pupils in some of primary schools regarding personal hygiene in Erbil city

Background: Hygiene is an old concept related to medicine awareness to personal and professional care practices related to most aspects of living. Inadequate sanitary conditions and poor hygiene practices play major roles in the increased burden of communicable disease within the developing countries.
Objectives: (1). Previous hand hygiene studies have indicated that children with proper hand washing practices are less likely to report gastrointestinal and respiratory symptoms (2). Schools should provide for hygiene education to kindergarten and early grade school children to supplement the training provided by parents and guardians, to ensure that all children learn at an appropriate age how to protect themselves and others of preventable exposure to illness and other hygienic hazards.
Methodology: Hand washing with soap has been reported to reduce diarrhea morbidity by 44% and respiratory infection by 23 % (3.) A study reported that 17% of participants washed their hands with soap after toilet, while 45% used only water (4). In addition to having proper resources and facilities hygiene practices are heavily influenced by pupil's knowledge and attitudes towards hygiene (5). Hygiene in school, home, and every day life settings plays an important part in preventing spread of infectious diseases (6). Beginning in the early nineteenth century the repeated onslaught of diseases such as cholera begins to alter people's understanding of personal hygiene.Hygiene practices are preventive measures to reduce the incidence and spreading of disease and are parts of good personal grooming (7). Hygiene as a system included not only personal hygiene related to food, clothing and exercise but also sciences such as engineering, bacteriology, public sanitation and waterworks (8). School teachers are considered the major source of information for their students and would appear to be suitable as health educators. School teachers are expected to be role models so that students can emulate and adopt their behavior and attitudes9.


Introduction:
Hygiene is an old concept related to medicine awareness to personal and professional care practices related to most aspects of living.Inadequate sanitary conditions and poor hygiene practices play major roles in the increased burden of communicable disease within the developing countries (1) .Previous hand hygiene studies have indicated that children with proper hand washing practices are less likely to report gastrointestinal and respiratory symptoms (2 ).Schools should provide for hygiene education to kindergarten and early grade school children to supplement the training provided by parents and guardians, to ensure that all children learn at an appropriate age how to protect themselves and others from preventable exposure to illness and other hygienic hazards.Hand washing with soap has been reported to reduce diarrhea morbidity by 44% and respiratory infection by 23 % (3.)A study reported that 0 17% of participants washed their hands with soap after toilet, while 45% used only water (4) .In addition to having proper resources and facilities hygiene practices are heavily influenced by pupil's knowledge and attitudes towards hygiene (5).Hygiene in school, home, and every day life settings plays an important part in preventing spread of infectious diseases (6).Beginning in the early nineteenth century the repeated onslaught of diseases such as cholera begins to alter people's understanding of personal hygiene.
Hygiene practices are preventive measures to reduce the incidence and spreading of disease and are parts of good personal grooming (7).Hygiene as a system included not only personal hygiene related to food, clothing and exercise but also sciences such as engineering, bacteriology, public sanitation and waterworks (8) .School teachers are considered the major source of information for their students and would appear to be suitable as health educators.School teachers are expected to be role models so that students can emulate and adopt their behavior and attitudes 9 . .

Objective:
To identify the student's knowledge and attitudes regarding personal hygiene.

Materials and Methods:
A descriptive study was carried out; one hundred of pupils were involved in some of the primary schools in Erbil city.The study began in Jan 20, 2011, through Apr 20, 2011.Questionnaire was designed for data collection and viewed to 10 experts in nursing field for validity and the questionnaire was consisted of two main parts as below.
Part one: socio demographic characteristics for study sample.
Part two: questions related to knowledge and attitudes about personal hygiene.
The Data was analyzed using the statistical packages for the social science SPSS version 11.5.

Discussion:
The findings of the study revealed that the majority of student were knows the requirement, and the importance of personal hygiene in preventing disease and infection as shown in (Table 3),this indicate that the student get good information about these factors from school and family as sources of acquiring knowledge and information.Another study supported findings in that all children said that their parents instructed them to wash their hands, prompted them to wash their hands, this supports the principle that health education should be included in the curriculum of grades 1 through 12 and continued in the community through adult education program (10) .Overall, the majority of students reported washing hands before meals.The percentages of children who reported the importance of and the preference for hand washing before eating were 99.7% and 98.8%, respectively (11) .
The result also reveals that the student knows the importance of healthy individual through the indicator of clean cloths good appearance as factors contributed for healthy pupils, a study conducted in East London showed that intensive hand hygiene interventions and caring of good appearance are feasible and acceptable but only temporarily during a period of a particular health threat such as an influenza pandemic (12) .The majority of student believed that they need more health education about personal hygiene as important indicator for good personal knowledge, 'Knowledge about the importance of Hygiene makes children more aware of other people around them (13) .and this also supported by a study which reveals that schools should provide for hygiene education to early grade school children to supplement the training provided by parents and guardians, to ensure that all children learn at an appropriate age how to protect themselves and others from preventable exposure to illness and other hygienic hazards (10) .Table (4) shows that there was significant relationship between age and their knowledge about personal at p value(0.010).,thisfindings is similar to study that shows children of all age groups had good knowledge of hygiene practices and germ transmission (11) .In the other study of school children grades 6-12 year, we assessed the knowledge, attitudes and practices of hygiene.Of the Students surveyed, 52% were classified as having proper knowledge of hygiene (11) .The age shows no significant relation with washing teeth, and washing hands before and after meals (Table 5, and   6).this mainly because the majority of them were washing their hands and teeth according to the request of their parents, overall our findings are consistent with previous studies that have documented knowledge and practices of hygiene among school children in developing countries (12) .For instance, studies from the Philippines and Colombia indicated that 75.9% and 46.9%of students, respectively, reported washing hands before meals.Table (7) result reveals that age have significant indicator on their knowledge about infectious disease and personal hygiene as many of them heard that from teacher as part of their lessons in science and continuing education in their school.It was found that students with adequate knowledge of fecal-oral contamination is a major cause of transmissible diseases such as gastrointestinal infections are less likely to have prevalent parasitic infections (12).Our study also reveals that age have certain effect on their knowledge about criteria of healthy individual, as person become older his insight about health and disease are increased (Table 8).These findings are in concurrence with a study conducted in the Philippines which found that 65% of students reported good bathing, and general hygiene related to their age (13).

Conclusions:
The study concluded that:  The majority of student were washing their teeth and hands, they knows the requirement of personal hygiene, their knowledge about the importance of hand washing were focused on it helps for disease prevention and for good appearance only.

Table 1 : Socio-demographic characteristics of study sample
It shows that the majority of them were female, and their age were over 10 years which represents (44%) of the sample.

Table 2 : Applying healthy measures
The result reveals that the majority of them were wash their teeth and hands

Table 3 : knowledge of student regarding personal hygiene
It shows that (94%) of students knows the requirement of personal hygiene, the majority of them also knows that importance of hand washing as for disease prevention and for good appearance, the result also reveals that (60%) of them believed that clean cloths is important indicator for healthy individual and (56%) of them believed that disease are the most important risk factor for improper personal hygiene and they wanted to have more health education about it

Table 4 : Do you know requirements for the personal hygiene
It shows that there was relationship between age and their knowledge about personal hygiene

Table 5 : Do you wash your teeth every morning
It reveals that age have no effect of their daily brushing their teeth

Table 6 : Do you wash your hands before and after meals
It shows that age have no effect on washing hands before and after meals

Table 7 : Is there any relationship between personal hygiene and infectious disease?
The result reveals that age have significant indicator on their knowledge about infectious disease and

Table 8 : Does you know the importance points that must be present in healthy individual?
It shows that the age have certain effect on their knowledge about criteria of healthy individual