title: The effect of Ebola Virus Disease outbreak on hand washing among secondary school students in Ondo State Nigeria, October, 2014.
abstract: BACKGROUND
  Hand washing with soap and water is one of the cheapest, most effective ways of limiting the spread of Ebola Virus Disease (EVD). Despite its importance the prevalence of hand washing was low before the EVD outbreak in Nigeria. This study aimed at determining the factors associated with improved hand washing practices following the EVD outbreak.
  
  
  METHODS
  A descriptive cross sectional study of 440 students from a secondary school in Owo, Ondo State was done. Data was collected in October 2014 when Nigeria was yet to be declared EVD free. Systematic random sampling was used. A semi-structured, interviewer administered questionnaire was used. Data was analysed with epi info version 7, descriptive statistics were done, Chi square test was used for the assessment of significant associations between proportions. Determinants of good hand washing practices was identified using logistics regression analysis at 5% level of significance.
  
  
  RESULTS
  Of 440 respondents, mean age was 13.7±1.9 years. Females were 48.2%. Only 4.6% have never heard of Ebola Virus Disease.Level of hand washing with soap and water improved by62.6%. Significant improvement in hand washing was in 75.8% of those who heard through social media (p < 0.001), 70.5% of Newspaper readers(p < 0.001), 65.6% of radio listeners (p = 0.001), 75.4% of family members p < 0.001, 76.3% talk in church p < 0.001, 77.6% peers p = 0.02, 72.4% TV p < 0.001. Change in hand washing practices was associated with watching television (AOR: 2.2; CI 95%: 1.1-4.3) and listening to health education in church (AOR: 2.4; CI 95%: 1.2-4.7).Major reason for change in hand washing practices was because of EVD deadly nature, 170(40.5%).
  
  
  CONCLUSIONS
  Watching health education messages on television and listening to it in church are the determinants of change in hand washing practices. Promotion of hand washing with soap and water needs to be sustained to prevent other diseases. Training of students on prevention of EVD was conducted in selected schools.
authors.affiliation: Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria.
authors.forename: Olayinka Stephen
authors.initials: OS
authors.lastname: Ilesanmi
authors.affiliation: Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria.
authors.forename: Faith Osaretin
authors.initials: FO
authors.lastname: Alele
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006235:Hand Disinfection / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D012574:Schools; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Ebola; Ebola Virus Disease; Hand-washing; Infection; Student