Hand-Washing Hygiene Knowledge, Attitude and Practice among University Students in the Post-COVID-19 Era: A Case of KCMC University, Moshi, Tanzania

Background: Hand hygiene is a key public health intervention for preventing infectious diseases, including respiratory and gastrointestinal infections. Although the COVID-19 pandemic improved awareness and compliance, sustained adherence remains a challenge, with evidence showing a decline in practice after outbreaks, particularly among young adults in high-contact settings such as universities. Therefore, this study aimed to assess the knowledge, attitudes, and practices of handwashing hygiene among university students at KCMC University, Moshi, Tanzania, in the post-COVID-19 era. Methods: A cross-sectional study was conducted among 380 students at KCMC University. Data were collected using a pretested structured questionnaire, which captured information on socio-demographic characteristics, knowledge, attitudes, and practices regarding handwashing hygiene. Data were analyzed using descriptive and inferential statistics. Associations between variables were assessed using logistic regression and multivariable analysis, and a p-value of <0.05 was considered statistically significant. Results: A total of 380 students participated in the study, with a mean age of 23.5 {+/-} 3.5 years. More than half 209 (55.0%) were aged 18-23 years, while 203 (53.4%) were female. Most participants had access to hand hygiene facilities 338 (88.9%). 338 (88.9%) participants had good knowledge of hand hygiene but attitudes were mostly negative 193 (50.8%), and practices were suboptimal, with 201 (52.9%) showing poor hand hygiene practices. Good hand hygiene knowledge was associated with access to hand hygiene facilities (AOR=2.84, 95% CI: 1.25-6.42, p=0.012) and formal training on hand hygiene (AOR=3.48, 95% CI: 1.24-9.76, p=0.018). Positive attitudes were associated with being in the fourth year or above (AOR=2.12, 95% CI: 1.16-3.89, p=0.015). Good hand hygiene practices were associated with access to hand hygiene facilities (AOR=2.67, 95% CI: 1.18-6.01, p=0.018) and formal training on hand hygiene (AOR=2.98, 95% CI: 1.19-7.48, p=0.020). Conclusion: Although knowledge and awareness of handwashing hygiene were generally high among university students, inconsistencies between knowledge and actual practices were observed in the post-COVID-19 era. Strengthening health education programs and ensuring continuous access to handwashing facilities may improve adherence to proper hand hygiene practices among university students.