ABSTRACT

The purpose of the study is to show hand washing can reduce respiratory infections. Specially
to compare the incidence of infection between school applying frequent hand-washing and
school which is not and observe whether incidence of school absteeinsm is related to the
incidence of infection. The methodology used in this research is randomized trial in 2
different elementary school in Tangerang. This survey involved 80 participants are 39
students of 3
rd
grade in SD Islamic Village which applying hand- washing and 39 students of
3
rd
grade in SDN 1 Karawaci with no intervention as control. We provided an antiseptic soap
for a group of students in SD Islamic Village and applied hand-washing in 39 students. We
informed the students to always wash their hands after doing activities with their hands,
especially before eating. After that we see in 2 weeks. This research used chi square to
analyze the data to find the correlation with significant level set at p< 0,05. The result from
this research is X
2
= 0, with the significant level at 5 % (0,05) and the degree of freedom of 1
from the table of chi square the critical value is 3.8415. So there is no relation between hand
washing and the decreased incidence of infection found from this research.

INTRODUCTION
Sometimes children with certain infection diseases are usually advised to stay away
from school both for the benefit of the child as well as to ensure that the infection is not
transmitted from one child to another. Furthermore, schools have been recognized as playing
a major role in the spread of influenza during an epidemic and are therfore of particular
public health importance for the control of infection.
From the data it showed 20% incidence of intoxication occured at school and
influenza is the most common cause of infection in 2002-2004. Based on Riskesdas, 2008
35% respiratory infection occur in children aged 1-4 years. Scientific studies conducted by
Curtis and Cairncross (2003) suggest that the behavior of hand washing with soap, especially
after playing and before eating can reduce the incidence of respiratory infection.
Some respiratory tract infections, including influenza H1N1 and the SARS- causing
corona virus, are also transmitted in part by the hands. Proper hand washing with soap is an
effective preventative measure againts these infections as well.
The aim of hand washing is to remove microorganisms from the hands, preventing
their potential transfer. It is known that organism survive and multiply on human hands,
creating the opportunity to infect others or the host. Hand washing reduces the number of
transient organisms on the skin surface. Although hands cannot be sterilized, most transient
organisms cn be removed by 30 seconds of proper scrubbing with soap and`water hand
sanitizer.

MATERIAL AND METHOD
Researh Design
For this research we used randomized trial method in 2 different elementary schools in
Tangerang from June 1
st
until June 14
th
2012.
Population and Samples
The subjects of this research are 3rd grader from 2 different elementary school in Tangerang.
39 students from SD Islamic Village and 39 students from SDN 1 Karawaci.
Data collection
The result of this research was collected in 2 weeks, and processing data of this study for 2
weeks, so we made in to 4 weeks. Consist of 78 students divided into 2 groups.
Inclusion and exclusion criteria
Inclusion criteria:
The 3rd grader student of elementary school
Actively participating in the study process
Applying the hand washing at school
Exclusion criteria:
The students other than 3rd grader of elementary school
Do not participating in the study process
Refuse to do the hand washing
Statistical analysis
Data were collected and recorded on the study from. This research use chi square to analyze
the data significant level set at p< 0.05.

RESEARCH RESULT
Table I Distribution of Infection at School ( observed )
Infection No Infection Total
SD Islamic Village 0 39 39
SDN 1 Karawaci 0 39 39
Total 0 78 78

Table II Distribution of Infection at School ( Expected )
Infection Non Infection Total
SD Islamic Village 0 39 39
SDN 1 Karawaci 1 38 39
Total 1 77 78

1. Determination of Chi-square value
The distribution data of infection expected is determined by formula : Ef =

Ef = Expected frequency
fk = Total frequency in column
fb = Total frequency in row
T = Total frequency of column and row
So the frequency expected :
Respiratory infection :

= 0

The general formulation of Chi-square is:

X
2
=

Where:
X
2
= Chi-square value
Ef = expected frequency
Of = observed frequency
So the sum value of chi-square for each category is 0.

2. Hypothesis
H
1
= there is a significant relation between hand washing and the decreased incidence
of infection among elementary school students.
H
2
= there is no significant relation between hand washing and the decreased
incidence of infection among elementary school students.

3. Determination of critical value
Degree of freedom : ( k-1 ) (1 1)
Where, k is total category of variable 1 (respiratory infection) and 1 is total category
of variable 2 (2 elementary schools)
So the degree of freedom is : (1-1) (2-1) = 0
With the general formulation of Chi-square : X
2
(df)= ( O E ) / E, the result from
this research X
2
= 0 with degree of freedom = 0. With the significant level at 5%
(0.05) and the degree of freedom of 2 from the table of chi square the critical value is
3.8415.

4. Result conclusion
If X
2
< critical value, null hypothesis is accepted.
If X
2
> critical value, null hypothesis is not accepted.
Therefore with X
2
= 0 at significant level at 5% (0.05) and the critical value 3.8415,
the null hypothesis is accpeted, which means there is no significant relation between
hand washing and the decreased incidence of infection in 2 schools observed in this
research.

DISCUSSION

The first step to protect our body from the infection outside the body is
keeping clean the media of our body as a transport to enter the infection. One of them
is keeping our hands clean and still hygiene. It is one of the way that we can do to
avoid the spreading infection. Washing our hands with soap has function to reduce the
infection in our hands. Hand washing is one of the promotion intervention that can
interrupt the transmission of respiratory infection causing pathogenes.
In 2005, WHO ( world health organization ) gave a message to wash our
hands with 7 steps but in fact many of health institute develop it until 10 steps. For
people in medicine or as health workers they should doing this more dicipline and
follow standart procedure which is provided in every hospital or public health.
Based on this research 0% participant in Islamic Village elementary school is
free from respiratory infection. As the comparison in SDN Karawaci 1 without
intervention (hand washing ) also free from respiratory infeection. This result show
that hand washing do effective in reducing or prevent infections, but is not significant.
As other research suggest, another internal and environmental factors can also affect
the result. These factor such as immunity, personal hygiene, and environmental
hygiene. The environmental hygiene should be assesed through prolonged observation
on school hygiene such as the cafetaria around the school or where the students have
their foods. Personal hygiene also be assed and this need the cooperation of people
around the students, teachers and family. Immunity is also consider to be assesed but
needs a bigger study.

CONCLUSION
Sometimes, something easy to do could be a hard way if we never wanna to
try and make it usual. Hand washing is the easy way to do but sometimes it can be
forgotten by every one and its the most effective ways to prevent the spread of many
types of infection and illness. With washing our hands, we can stop spreading the
germs from one person to another.
Some researchers had also proved that the hand washing has a significant
effect on infections. From many researchers, their said that hand washing can be an
effective primary prevention.
Based on our research about the effectivities of hand washing, we found that
the effectivities of hand washing for reduce respiratory disease. But it cant reduce
total laboratory-confirmed influenza. Beside we should prevent the hygiene of the
children with hand washing, we also should giving information about the other cause
of infectious an how to prevent that.
Another cause may be due to some factors such as personal hygiene of each
students whether at home or school. Another factor such as immunity cant be
ignored. This different result need to be assessed more specifically.
Although we cant prove the hypothesis in this research, the information about
the infection and the prevention is very important since Indonesia is an endemic for
tropical infections.