Hand Contamination and Associated Health Risks in Developing Countries: A Systematic Review of the Public Health Challenges and Implications

Abstract

Introduction: The study is a systematic review focusing on the contamination of hands and how it results in the spread of infectious diseases, as well as health risks and challenges associated with it. Method: We systematically reviewed studies published using keywords and short medical terms/phrases between 1871 and 2026 from Google Scholar, PubMed, Cochrane Library, Global Health, and BIOSIS. No restrictions were placed on language or study type. The database search was supplemented with data from experts for unpublished observations. Results: A total of 129 studies were included and reviewed in this work. Based on the systematic reviews, 36.4%, 22.5%, and 7% of the papers reviewed were from developing countries in Africa, Asia, and South America. Identified health risks associated with contaminated hands include dirty classrooms in primary schools with 14.7% prevalence as the highest, followed by poor housing infrastructures at 9.3%, while the least was crisis and conflict contributing 1.6%. The interventions identified were handwashing practices and facilities contributing the highest at 10% prevalence, while educating breastfeeding mothers, 5.4% of the interventions, and national campaigns on handwashing and availability of running water were the least at 1.6%. Finally, infectious bacterial agents identified Campylobacter spp, having a prevalence of 10%. Methicillin-resistant Staphylococcus aureus (MRSA) with 7%, while Vibrio cholerae (non-outbreak) and Acinetobacter baumanii had the least occurrence at 1.6%. Conclusion: Handwashing is the singular most important intervention in preventing the transmission of infectious diseases. However, challenges such as inadequate or a lack of education, poor and inadequate toilet facilities, cultural backgrounds, religious beliefs, personal hygiene practices, and the immediate inanimate environment have been observed as the major factors associated with handwashing and transmission of infectious diseases in developing countries.