A nationwide survey on some hygienic behaviors of Iranian children and adolescents: the CASPIAN-IV study

Background: this study aims to assess the frequency of some hygienic behaviors that is,tooth brushing and hand-washing,in iranian school students at national level.methods: this nationwide study was conducted in 2011-2012 among 14,880 elementary,secondary and high school students who were selected by random cluster stratified multistage sampling from 30 provinces in iran. we used the global school-based health survey questionnaire of the world health organization.results: the population of this survey consisted of 13,486 children and adolescents (participation rate of 90.6%) including 49.2% girls and 75.6% urban inhabitants. the mean age of participants was 12.5 years (12.3-12.6,95% confidence interval) according to the self-report of students,26.9% of them (20.2% of boys and 33.9% of girls) brushed their teeth more than once a day,37.8% of boys and 42.1% of girls brushed their teeth once a day. in general,girls brushed their teeth more than boys. the frequency of those students who never brushed their teeth was twice in rural than in urban students (11.4% vs. 6.2%,respectively). in total,3.4% of the students stated that their school had not an appropriate place for washing hands after toilet,with three-fold higher frequency in rural than in urban schools (6.8% vs. 2.3%,respectively). 85% of students (87% of girls vs. 83% of boys) reported that they had always washed their hands after toilet,10.1% did it occasionally and 4.1% did not.conclusions: this nationwide survey revealed that iranian students have an acceptable level of hygienic behaviors both in urban and rural areas; however,still it is necessary to improve school health facilities and hygienic habits in iranian students.