Infection prevention and control in a treatment centre during a Lassa fever outbreak in southeastern Nigeria - January, 2018

Abstract

Introduction: Lassa fever (LF) is a communicable viral haemorrhagic disease. Person-to-person spread occurs by inhalation or direct contact with the bodily fluids of an infected patient. Infection Prevention and Control (IPC) is essential in healthcare facilities for the wellbeing and safety of patients, staff and visitors. Federal Teaching Hospital, Abakaliki is the designated treatment center for LF in Ebonyi State. We assessed IPC practices in this facility during the 2018 outbreak of LF involving healthcare workers. Methods: We conducted a cross-sectional study on 135 healthcare workers selected by systematic sampling. Information on their knowledge and practice of IPC was collected using a pre-tested, semi-structured questionnaire. We classified knowledge into "good", "fair" and "poor" based on the total correct response. Those that scored ≥75% of the maximum score were classified as good, 50-74% as fair and <50% as poor. We calculated prevalence odds ratio and 95% confidence intervals of the odds ratio to determine the factors associated with good knowledge scores. We purposively sampled key units involved in the management of suspected Lassa fever cases and assessed the availability of basic IPC requirements. Results: The mean age of the respondents was 37.6 ± 7.6 years and 75 (55.6%) were females. Fifty-seven (42.5%), 29 (21.6%) and 13 (9.9%) respondents claimed always to have gloves, running water and hand washing soaps, respectively, in their units. The proportion of respondents with good knowledge of IPC measures was 71.8%, while 58.5% and 37.8% had good knowledge of LF epidemiology and LF clinical features, respectively. Being a core health worker (OR: 3.39 95%CI: 1.38-8.32) was significantly associated with good knowledge of LF epidemiology. Being male (OR: 1.55 95%CI: 0.72-3.34) and having spent >15years in the facility (OR: 1.16 95%CI: 0.39-3.44) were associated with good knowledge of IPC precautionary measures. However, these associations were not statistically significant. Conclusions: The majority of the staff had good knowledge of IPC. However, knowledge of LF epidemiology was greater among those whose roles were related to management of LF cases. We recommended more awareness on LF, IPC practices and improved supply of IPC commodities.

Knowledge, attitude and practice of infection prevention and control among healthcare workers: one year after an outbreak of nosocomial Lassa fever in a tertiary hospital in southeast NigeriaKnowledge, attitude and practice of infection prevention and con

“…Routine assessment of health systems is key to improving healthcare services delivery through identifying strengths and weaknesses and working towards fixing identified weaknesses. In our study location, there was an initial assessment of IPC which identified gaps during the nosocomial outbreak in 2018 (8,9). Several interventions had been carried out in the hospital to improve IPC after the initial assessment, and the hospital management in conjunction with her partners had organized series of training on IPC among its health workforce.…”

“…A self-administered questionnaire was used to collect information from each respondent. The questionnaire was adapted from previous studies (9,12), and consisted of 4 sections. Section A obtained data on the sociodemographic characteristics of the respondents.…”

“…Each correct question attracted a score of one and a wrong answer was scored zero. Respondents were classified as having good knowledge if they scored ≥75% of the total scores, fair if scores were 50-74% and poor if <50% (9).…”

“…The State has been recording outbreak of Lassa fever since 2005 (6), with several events of nosocomial spread of the infection among HCWs in the State (6)(7)(8). Following the outbreak of Lassa fever in 2018, an assessment was done in the study location by the National Rapid Response Team deployed for the outbreak in the State, and the assessment revealed that there were gaps in the practice and infrastructure for IPC in the hospital (9). Recommendations were also made by the Team which included raising awareness of IPC among the HCWs and provision of necessary materials for IPC (9).…”

“…Following the outbreak of Lassa fever in 2018, an assessment was done in the study location by the National Rapid Response Team deployed for the outbreak in the State, and the assessment revealed that there were gaps in the practice and infrastructure for IPC in the hospital (9). Recommendations were also made by the Team which included raising awareness of IPC among the HCWs and provision of necessary materials for IPC (9). Some interventions had been instituted to improve the IPC framework in the State and the study location.…”