Status and influence factors of hand hygiene compliance among kindergarten children in Shenzhen city

Objective To investigate the status and influence factors of hand hygiene compliance (HHC) among kindergarten children in Shenzhen city.Methods Totally 2 461 children were selected from 18 kindergartens in Nanshan and Baoan districts of Shenzhen city with stratified random cluster sampling and 4 449 hand-washing situations of the children were observed and environmental factors associated HHC of the children were also analyzed.Results The overall rate of HHC was 29% among the children.The children in private kindergartens showed an obvious higher rate of HHC (48.7%) than those in the public kindergartens (30.4%) and the kindergartens for migrant population (12.9%);the children in kindergartens at municipality level demonstrated an apparent higher rate of HHC (51.1%) than those in kindergatens at province level (32.9%),district level (17.7%),and the kindergartens not being assigned an administrative level (0.0%);the children in a lower glass had a higher HHC rate (38.7%) than those in a middle (31.8%)or an upper glass (17.0%).Among the children,the highest HHC rate was observed before they having a meal,followed by that after playing outside (47.7%),when having an obvious dirty hand(21.8%),after toilet use(19.8%),and before preparing food (0.0%).Multivariate analyses revealed that the number of soap dispenser distributed in a kindergarten (odds ratioOR=1.176,95% confidence interval95%CI:1.092-1.268),reminders for washing hand from teachers (OR=13.616,95%CI=:9.431-19.660),and the age of a child (OR=5.064,95%CI=3.796-6.575) were significantly associated with HHC among the children.Conclusion The hand hygiene compliance is generally low among kindergarten children in Shenzhen city and effective intervention measures should be developed to improve hand hygiene compliance in the children.