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.