Background
Methods
Study area and design
Participants and data collection
Demographics | Overall (%) [N = 240] | National HDB data [26] (%) |
---|---|---|
Median Age
| 41.5 | 39 |
Interquartile Range | 32-52 | |
Gender
| ||
Female | 122 (50.8) | (51.2) |
Marital Status
| ||
Married | 184 (76.7) | (76.5) |
Ethnicity
| ||
Chinese | 159 (66.3) | (73.5) |
Malay | 30 (12.5) | (15.6) |
Indian | 32 (13.3) | (8.9) |
Others | 19 (7.9) | (2) |
Citizenship
| ||
Singaporean | 182 (75.8) | (82) |
Education
Ɨ
| ||
Post-Secondary | 120 (50) | (51.4) |
Occupation
| ||
Employed | 158 (65.8) | (64) |
Household members
| ||
<3 | 37 (15.4) | (28.8) |
3-5 | 145 (60.4) | (63.8) |
>5 | 58 (24.2) | (18.4) |
At least 1 Child <5 Years Old
| 55 (22.9) | (5.1) |
Residence
| ||
2-3 Room | 29 (12.1) | (23.7) |
4 Room | 133 (55.4) | (41.1) |
5 Room-Executive | 78 (32.5) | (35.2) |
Diabetes
| 11 (4.6) | (11.3)+ |
Hypertension
| 34 (14.2) | (23.5)+ |
Asthma
| 4 (1.67) | - |
Allergy
| 9 (3.8) | - |
Smoker
| 48 (20) | (14.3)+ |
Diarrhoea*
#
| 60 (25) | - |
Flu*^
| 73 (30.4) | - |
Data management and analysis
Results
Hand hygiene knowledge, attitude and behaviour
Questions* | (N = 240) | % | |
---|---|---|---|
Hand Hygiene - Practice and Behaviour
| |||
Q1 How often do you wash your hands a day? | |||
Never | 0 | 0.0 | |
1-3 times | 18 | 7.5 | |
4-8 times | 106 | 44.2 | |
>8 times | 116 | 48.3 | |
Q2 How often do you wash your hands with soap a day? | |||
Never | 4 | 1.7 | |
1-3 times | 65 | 27.1 | |
4-8 times | 110 | 45.8 | |
>8 times | 61 | 25.4 | |
Q3 How often do you wash your hands with alcohol-based disinfectant a day? | |||
Never |
192
|
80.0
| |
1-3 times | 33 | 13.8 | |
4-8 times | 9 | 3.8 | |
>8 times | 6 | 2.5 | |
Q4Ɨ Do you wash your hands…. | Median Score (IQR) | 21 | 17-23 |
A. When your hands are visibly dirty? | Response: Soap |
211
|
87.9
|
B. Before eating? | Response: Soap | 117 | 48.8 |
C. Before handling food or cooking? | Response: Soap | 141 | 58.8 |
D. After handling food or cooking? | Response: Soap | 179 | 74.6 |
E. After defecation? | Response: Soap |
207
|
86.3
|
F. After a toilet trip? | Response: Soap | 174 | 72.5 |
G. After an outdoor physical activity? | Response: Soap | 176 | 73.3 |
H. Before attending to a child or sick person? | Response: Soap | 134 | 55.8 |
I. After attending to a child or sick person? | Response: Soap | 147 | 61.3 |
J. After sneezing or coughing? | Response: Soap | 103 | 42.9 |
K. After handling pets? | Response: Soap | 172 | 71.7 |
L. With preference of using | Response: Liquid Soap |
196
|
81.7
|
M. For about… | Response: >30s | 111 | 46.3 |
Q5 Do you follow… | |||
Step 1 of the 8 steps of hand washing? |
211
|
87.9
| |
Step 2 of the 8 steps of hand washing? | 176 | 73.3 | |
Step 3 of the 8 steps of hand washing? | 152 | 63.3 | |
Step 4 of the 8 steps of hand washing? | 82 | 34.2 | |
Step 5 of the 8 steps of hand washing? | 74 | 30.8 | |
Step 6 of the 8 steps of hand washing? | 64 | 26.7 | |
Step 7 of the 8 steps of hand washing? | 103 | 42.9 | |
Step 8 of the 8 steps of hand washing? | 180 | 75.0 | |
Q6 Do you feel it is troublesome washing your hands with soap? | 27 | 11.3 | |
Q7 Is hand washing with soap a habit for you? |
207
|
86.3
| |
Q8 Do you think you will encourage your family members and friends to pick up hand washing with soap, if they have not? | 187 | 77.9 | |
Q9 Do you think you will wash your hands with soap more often during disease outbreaks like the previous H1N1 or SARS? | 189 | 78.8 | |
Q10 Do you cover your mouth when you sneeze? |
223
|
92.9
| |
Q11 Do you wear a mask in public when you are sick? | 75 | 31.3 | |
Food Hygiene - Practice and Behaviour
| |||
Q12 Do you keep fresh food such as vegetables and meat separately in the refrigerator with the appropriate temperature? |
232
|
96.7
| |
Q13 Do you wash your food properly before cooking? |
240
|
100.0
| |
Q14 Do you have a chopping board that is only for vegetables, and another one just for meat? | 136 | 56.7 | |
Q15 Do you check the expiry date on the food packaging before purchasing or cooking the food? |
226
|
94.2
| |
Q16 Do you ensure the food is well-cooked before consumption? |
236
|
98.3
| |
Q17 Do you leave cooked food at room temperature for longer than two hours? | 118 | 49.2 | |
Q18 Do you reheat leftover food before consumption? |
212
|
88.3
| |
Q19Do you choose hawker stalls based on… | |||
Their cleanliness grades awarded by NEA | 47 | 19.6 | |
The good recommendation of their food | 98 | 40.8 | |
The cleanliness of the stalls and the hygiene measures taken by their chef(s) | 95 | 39.6 | |
Q20 Do you choose restaurants based on… | |||
Their cleanliness grades awarded by NEA | 89 | 37.1 | |
The good recommendation of their food | 151 | 62.9 | |
Q21 Will you provide feedback to the…. | |||
Restaurant or hawkers or food handlers if you have diarrhoea after consuming their food | 83 | 34.6 | |
NEA/MOH if you have diarrhoea after consuming food at a hawker or restaurant | 47 | 19.6 | |
None of the above | 140 | 58.3 | |
Q22 Would it be useful to have a web-portal or apps that you can report your diarrheal case? | 152 | 63.3 | |
Q23 When you have diarrhoea do you prefer to…. | |||
Self-medicate | 89 | 37.1 | |
Visit a GP | 118 | 49.2 | |
Visit polyclinic | 7 | 2.9 | |
Visit the hospital | 26 | 10.8 | |
Hand Hygiene - Knowledge and Attitude
| |||
Q24 Do you agree that washing your hands with soap can help to reduce the spread of diseases, like HFMD and flu? |
232
|
96.7
| |
Q25 Do you agree that washing your hands with soap can protect you from diarrheal diseases? |
195
|
81.3
| |
Q26 Do you agree that washing your hands with soap is more effective in the removal of pathogens than without soap? |
231
|
96.3
| |
Q27 Do you agree that washing your hands with alcohol based disinfectant is more effective than with soap? | 138 | 57.5 | |
Q28 Do you agree that the 8 steps for washing hands technique is effective in the removal of pathogens? |
214
|
89.2
| |
Q29 Do you agree that washing your hands with soap using the 8 steps for washing hands is important? |
207
|
86.3
| |
Q30 Do you agree that there should be more provisions for alcohol-based disinfectants on public transport systems, such as at the MRT stations or on the buses? | 183 | 76.3 | |
Q31 Do you agree that washing your hands keeps your hands too clean and it may lower your immunity against pathogens? | 111 | 46.3 | |
Q32 Do you agree that the emphasis on hand hygiene should be enforced since kindergarten? |
236
|
98.3
| |
Q33 Do you agree that you can reduce transmission of disease by covering your mouth when you sneeze? |
234
|
97.5
| |
Q34 Do you agree that wearing a mask can reduce transmission of disease when you have flu-like symptoms? |
228
|
95.0
| |
Q35 Do you think an annual hygiene campaign will be effective in encouraging you to have good hand hygiene practice? |
206
|
85.8
| |
Food Hygiene - Knowledge and Attitude
| |||
Q36 Do you agree that good food hygiene can help to reduce diarrheal incidence? |
232
|
96.7
| |
Q37 Do you agree that it is important to keep fresh food such as vegetable and meat separately in the refrigerator with the appropriate temperature? |
234
|
97.5
| |
Q38 Do you agree that proper washing of food before cooking can help to reduce the chance of diarrheal incidence? |
235
|
97.9
| |
Q39 Do you agree that leaving cooked food at room temperature for longer than two hours can increase the chance of diarrheal incidence? | 182 | 75.8 | |
Q40 Do you agree that leftover food should be reheated before serving? |
224
|
93.3
| |
Q41 Do you agree that checking the expiry date before purchasing or cooking the food can help to reduce the chance of diarrheal incidence? |
233
|
97.1
| |
Q42 Do you agree that using different chopping boards for meat and vegetables can help to reduce the chance of diarrheal incidence? | 181 | 75.4 | |
Q43 Do you agree that well-cooked food can help to reduce diarrheal incidence? |
237
|
98.8
| |
Q44 Do you agree that the emphasis of food hygiene should be enforced since kindergarten? |
234
|
97.5
| |
Q45 Do you think an annual hygiene campaign will be effective to encourage you to have good hygiene practices? |
216
|
90.0
|
Food hygiene knowledge, attitude and behaviour
Risk factors of diarrhoea
Diarrhoea# | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Variables | None N = 180 | % | Yes N = 60 | % | p-value^ | Crude OR | p-value | 95 % CI Range | Adjusted OR+ | p-value | 95 % CI Range | ||
Median Age
| 43 | 36 |
0.0188
|
0.98
|
0.0204
| 0.96 | 1.00 | 0.99 | 0.4421 | 0.97 | 1.01 | ||
(Interquartile Range) | (33–55) | (29–45.25) | |||||||||||
Marital Status
| |||||||||||||
Married | 145 | 80.6 | 39 | 65.0 | 1.00 | 1.00 | |||||||
Single | 35 | 19.4 | 21 | 35.0 |
0.0211
|
2.23
|
0.0150
|
1.16
|
4.25
|
2.29
|
0.0154
|
1.16
|
4.48
|
Ethnic Group
| |||||||||||||
Chinese | 117 | 65.0 | 42 | 70.0 | 1.00 | 1.00 | |||||||
Malay | 19 | 10.6 | 11 | 18.3 | 1.61 | 0.2544 | 0.69 | 3.63 | 1.53 | 0.3276 | 0.64 | 3.58 | |
Indian | 29 | 16.1 | 3 | 5.0 |
0.29
|
0.0492
|
0.07
|
0.87
| 0.31 | 0.0727 | 0.07 | 0.98 | |
Others | 15 | 8.3 | 4 | 6.7 | 0.0711 | 0.74 | 0.6149 | 0.20 | 2.18 | 0.69 | 0.5509 | 0.18 | 2.15 |
Flu
#
| |||||||||||||
No | 137 | 76.1 | 30 | 50.0 | 1.00 | 1.00 | |||||||
Yes | 43 | 23.9 | 30 | 50.0 |
0.0003
|
3.19
|
0.0002
|
1.73
|
5.90
|
3.24
|
0.0002
|
1.74
|
6.06
|
Q4H
| |||||||||||||
None | 20 | 11.1 | 12 | 20.0 | 1.00 | 1.00 | |||||||
Water only | 62 | 34.4 | 12 | 20.0 |
0.32
|
0.0190
|
0.12
|
0.83
|
0.30
|
0.0194
|
0.11
|
0.82
| |
Water and Soap | 98 | 54.4 | 36 | 60.0 |
0.0495
| 0.61 | 0.2359 | 0.27 | 1.41 | 0.56 | 0.1917 | 0.24 | 1.36 |
Q4I
| |||||||||||||
None | 12 | 6.7 | 14 | 23.3 | 1.00 | 1.00 | |||||||
Water only | 57 | 31.7 | 10 | 16.7 |
0.15
|
0.0003
|
0.05
|
0.41
|
0.16
|
0.0008
|
0.05
|
0.45
| |
Water and Soap | 111 | 61.7 | 36 | 60.0 |
0.0009
|
0.28
|
0.0034
|
0.12
|
0.65
|
0.29
|
0.0077
|
0.12
|
0.72
|
Q4M
| |||||||||||||
<30 sec | 89 | 49.4 | 40 | 66.7 | 1.00 | 1.00 | |||||||
30 sec – 60 sec | 63 | 35.0 | 12 | 20.0 |
0.42
|
0.0197
|
0.20
|
0.85
|
0.44
|
0.0302
|
0.20
|
0.90
| |
>60 sec | 28 | 15.6 | 8 | 13.3 | 0.0543 | 0.64 | 0.3074 | 0.25 | 1.46 | 0.81 | 0.6472 | 0.31 | 1.95 |
Q16
| |||||||||||||
No | 0 | 0.0 | 4 | 6.7 | 1.00 | 1.00 | |||||||
Yes | 180 | 100.0 | 56 | 93.3 |
0.0036
|
0.01
|
<0.0001
|
0.00
|
6487.54
|
0.01
|
<0.0001
|
0.00
|
2979.95
|
Q20*
| |||||||||||||
0 | 106 | 58.9 | 45 | 75.0 | 1.00 | 1.00 | |||||||
1 | 74 | 41.1 | 15 | 25.0 | 0.0305 |
0.48
|
0.0271
|
0.24
|
0.90
| 0.52 | 0.0606 | 0.26 | 1.01 |
Q21*
| |||||||||||||
0 | 99 | 55.0 | 41 | 68.3 | 1.00 | 1.00 | |||||||
1 | 54 | 30.0 | 16 | 26.7 | 0.72 | 0.3245 | 0.36 | 1.37 | 0.69 | 0.2974 | 0.33 | 1.37 | |
2 | 27 | 15.0 | 3 | 5.0 | 0.0682 |
0.27
|
0.0387
|
0.06
|
0.81
|
0.26
|
0.0393
|
0.06
|
0.82
|
Q23
| |||||||||||||
Visit a GP | 95 | 52.8 | 23 | 38.3 | 1.00 | 1.00 | |||||||
Self-medicate | 61 | 33.9 | 28 | 46.7 |
1.90
|
0.0496
|
1.00
|
3.62
|
2.07
|
0.0346
|
1.06
|
4.12
| |
Visit Hospital | 6 | 3.3 | 1 | 1.7 | 0.69 | 0.7354 | 0.04 | 4.31 | 0.45 | 0.4796 | 0.02 | 3.03 | |
Visit Polyclinic | 18 | 10.0 | 8 | 13.3 | 0.1836 | 1.84 | 0.2098 | 0.68 | 4.65 | 1.81 | 0.2570 | 0.63 | 4.94 |