<b>Assessing Knowledge Level Regarding Hand Hygiene Among School-Going Students at Charsadda, KPK, Pakistan: A Cross-Sectional Study</b>

Introduction: Hand hygiene is a proven, cost-effective method for reducing the spread of infectious diseases, yet gaps remain between awareness and consistent practice, particularly in school settings. In Pakistan, limited evidence exists on adolescents’ hand hygiene knowledge, especially in Charsadda, Khyber Pakhtunkhwa, where infrastructural and educational barriers may hinder compliance. Objective: To assess the knowledge of hand hygiene practices among matriculation-level school students in Charsadda, with emphasis on identifying demographic, educational, and infrastructural factors associated with knowledge levels. Methodology: A descriptive cross-sectional survey was conducted among 327 matriculation-level students from 15 private schools in Charsadda between August 25 and November 20, 2024. Participants were selected through convenience sampling. Data were collected via a validated questionnaire (CVI 0.83, Cronbach’s alpha 0.71) and analysed using SPSS version 27. Descriptive statistics summarized demographics and questionnaire responses; Chi-square tests with Cramer’s V assessed associations between gender, residence, and knowledge level, with p<0.05 considered statistically significant. Results: The sample was predominantly male (82.0%) and rural (59.0%). Overall, 97.9% recognized hand hygiene as important, yet only 33.0% reported regular practice in school. Knowledge of proper handwashing was reported by 77.7%, but 27.8% believed water alone suffices. Only 20.8% had been exposed to school hygiene campaigns, and 50.5% lacked soap and water access at school. Gender was significantly associated with high knowledge (p=0.001, Cramer’s V=0.18), favoring males; residence showed no association (p=0.137). Conclusion: While awareness of hand hygiene is high among Charsadda’s matriculation-level students, practical adherence is limited by resource availability, low campaign exposure, and persistent misconceptions. Integrated strategies combining education, infrastructure provision, and institutional reinforcement are essential to bridge the knowledge–practice gap and improve long-term health outcomes.