Prevalence and factors associated with suboptimal hand and oral hygiene behavior among adolescents in Central America

Introduction The aim of the study was to assess the prevalence and associated factors of hand hygiene (HH) and oral hygiene (OH) behavior in adolescents in Central America. Methods In total, 15807 school-aged adolescents (mean age=14.4 years, SD=1.4) were analyzed using secondary data from the cross-sectional Global School-based Student Health Survey (GSHS) conducted in six Central American countries (El Salvador, Belize, Costa Rica, Guatemala, Honduras, and Panama) between 2009 and 2018. HH and OH were assessed by questionnaire. Adjusted logistic regression was used to determine the associations with suboptimal (‘not always’) HH (SHH) and suboptimal (<2 times/day) OH (SOH). Results The proportion of SHH before meals was 44.5% (the highest in Panama 69.0%), SHH after toilet use was 21.5% (the highest in Panama 33.3%), SHH with soap was 51.0% (the highest in Honduras 83.1%), and SOH (<2 times tooth brushing/day) was 11.3% (the highest in Panama 13.0%). Male sex (AOR=1.10; 95% CI: 1.03–1.35, SHH after toilet use), health risk behavior, including history of alcohol intoxication (AOR=1.54; 95% CI: 1.32–1.81 for SHH before meals, AOR=1.49; 95% CI: 1.23–1.99 for SHH after toilet use, and AOR=1.35; 95% CI: 1.17–1.57 for SHH with soap), inadequate fruit intake (AOR=1.53; 95% CI: 1.33–1.76 for SHH before meals and AOR=1.57; 95% CI: 1.34–1.84 for SHH after toilet use), inadequate vegetable intake (AOR=1.24; 95% CI: 1.05–1.47 for SHH before meals), and sedentary behavior (AOR=1.45; 95% CI: 1.28–1.64 for SHH before meals and AOR=1.23; 95% CI: 1.11–1.37 for SHH with soap), and poor mental health, including having no close friends (AOR=1.53; 95% CI: 1.20–1.96 for SHH before meals, and AOR=1.51; 95% CI: 1.22–1.99 for SHH after toilet use), and suicidal ideation (AOR= 1.22; 95% CI: 1.01–1.47 for SHH after toilet use, and AOR=1.27; 95% CI: 1.11–1.45 for SHH with soap) were associated with SHH. Male sex (AOR=1.80; 95% CI: 1.55–2.10), having no close friends (AOR=1.98; 95% CI: 1.50– 2.60), and suicidal ideation (AOR=1.32; 95% CI: 1.05–1.68) increased the odds and soft drink intake (AOR=0.75; 95% CI: 0.64–0.88) decreased the odds of SOH. Conclusions This study presents SHH and SOH behavior practices. Several factors, including sociodemographics, health risk behaviors, and poor mental health, were identified that were associated with SHH and SOH behaviors, which can help in designing school OH and HH health promotion.