Prevalence and Risk Factors of Poor Hand and Oral Hygiene Practices Among Adolescent Students in Eastern China: A Cross-Sectional Study

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Abstract
Purpose: This study aimed to investigate the current status and associated factors of hand and oral hygiene behaviors among adolescent students in Zhejiang Province, Eastern China. Methods: This study utilized a cross-sectional survey conducted in Zhejiang Province between April and June 2022. Data were collected through a self-administered, structured questionnaire that assessed tooth brushing frequency, hand washing practices before meals, after toilet use, and hand washing with soap. Multivariate logistic regression was performed to identify associations between hygiene practices and socio-demographic factors. Results: The study included 26,101 adolescent students. Of these, 29.25% had poor oral hygiene practices, and the majority brushed their teeth twice per day (51.43%). Regarding hand hygiene, 78.06% exhibited poor hand hygiene before meals, 24.67% after toilet use, and 82.56% when using soap. Multivariate logistic regression analysis indicated that higher parental education and greater family income were linked to a reduced likelihood of poor oral and hand hygiene practices. Conversely, older age and parental marital status (divorced, widowed, or separated) were linked to an increased risk of both poor oral and hand hygiene practices. Additionally, girls and only children were less likely to exhibit poor oral hygiene but more likely to have poor hand hygiene. Conclusion: The prevalence of poor hand and oral hygiene practices among adolescent students in Zhejiang Province, Eastern China was very high. Several socio-demographic factors were identified to guide future targeted interventions aimed at improving hygiene practices among this population.

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