To our knowledge, this is the first study conducted in Saudi Arabia that brings which have found a correlation between a variety of personal hygiene habits and influenza vaccine with the frequency of influenza-like illness.
This study found that handwashing with soap and rubbing was protective against influenza-like illness. Several studies were consistent with our findings [2, 20,21,22,23,24,25,26,27].
Participants spending 5–10 s in handwashing with soap and rubbing were at increased risk of more frequent influenza-like illness. Also, it turned out that handwashing with soap and rubbing before eating, after using the bathroom and after coming back home was protective from influenza-like illness regardless of the frequency. Interestingly Pires et al. have found that the time needed to kill bacteria, a person should rub for at least 15–30 s . So, this makes the duration of handwashing itself a crucial factor in prevention. Most people’s underestimate the value of washing hands to maintain clean hands regularly .
Furthermore, washing hands with soap and rubbing before and after shaking hands were also protective against having an influenza-like illness. This finding emphasizes the importance of washing hands before and after any action — what we would call good hygiene habits.
Although Aiello et al. have found in their meta-analysis study that hand washing alone was not enough for efficacy against laboratory-confirmed influenza. However, the total percentage of respiratory diseases prevented by hand-hygiene interventions was 21% (95% CI = 5, 34%). Moreover, hand-washing education done by non-antibacterial soap was a.
precise preventative measure, as it prevented 51% (95% CI = 39, 60%) of respiratory diseases in comparison with the controlled group that did not have an intervention . Nevertheless, Wong et al. have found that the overall impact of hand hygiene in protection from influenza was modest .
As there were previous statements from experts that using other people’s items might affect getting the influenza-like illness. However, the participants who used other people’s towel, straw, glass, and habli babli did get affected more frequently with influenza-like illness. Nevertheless, this increase was in the percentage and odds ratio, and it was not statistically significant.
It seemed like repeated touching of eyes and nose, and the action is done when sneezing (e.g., on hands, using napkins) did not affect the frequency of getting the influenza-like illness. Moreover, the annual vaccination against influenza protects against frequent influenza-like illness. There were several studies, which have supported our findings [31,32,33]. Annual influenza vaccines and handwashing with soap and rubbing after handshaking was independently protective against frequent influenza-like illness.
The current study supported the evidence of the link between handwashing with soap and rubbing and the decrease in the frequency of influenza-like illness. While, washing hands are considered applicable, easy to administer, and cost-effective, healthy habit that does not take a lot of time, yet protects us from many diseases. However, lack of proper hand hygiene is considered a global issue. Unfortunately, our finding leads us to think that people’s may tend to wash their hands only if there was visible dirt. Efforts regarding awareness of proper hand hygiene behavior need to be maximized.
Furthermore, the present study emphasizes the awareness of not just washing hands-on everyday occasions, such as before eating. It is recommended even on other circumstances such as after getting out of the bathroom, after coming back home, and before shaking hands. Although, the finding of this study regarding using shared items with others did not affect the frequency of getting influenza-like illness with statistical significance. However, this does not make it a healthy behavior, and therefore, caution must be taken, unless urgent situations force you to do so.
While there were previous statements regarding behaviors such as frequent touching of eyes and nose and sneezing in a wrong way, such as on hands might affect the frequency of influenza-like illness. Hence, these behaviors should not be considered significant points when preparing health promotion activities and materials. Although it is uncommon for a health provider to advise people to wash their hands with soap and to rub after shaking hands. The current study helps health providers and authorities to emphasize its importance. This study support the previous statements of experts in public health, who stated that vaccine could significantly play an essential role in the reduction of frequency of influenza-like illness.
The authors had to make the age group from 16 to 45 years, as in Saudi Arabia, the middle age group of 16–64 makes up the greatest share of the total population (64.8%). There was a chance of recall bias among the participants. However, the participants were asked to answer the questions based on their behavior in the last 4 weeks, which minimized the recall bias. The duration of hand-washing reported by participants might not have been accurate 100%. However, they were asked to have an approximate estimation, as it is difficult to bring all participants in one place, and observe the time they spend washing their hands. Finally, there might have been some participants who did not answer the questionnaire as they should due to un-clear comprehension of the questions. However, this matter has been addressed since the beginning, as each participant was approached individually, and was given a full explanation of each part of the questionnaire.