Effective Anti-Fogging Agent for Glasses and Face Shields in the Treatment of Ebola in Uganda: Implications for Healthcare Worker Safety and Patient Care

Abstract

Evidence on the effective Antifogging Agents (AFA) for use during Donning of goggles and face shields in Ebola Treatment Centres (ETC) is lacking. This study aimed at establishing an effective antifogging agent, the side effects of fogging, and the impact of fogging. It was a cross-sectional study conducted from 26 September to 08 October 2022 in Fort Portal Regional Referral Hospital Ebola Treatment Centre in which 21 Health Care Workers (HCWs) managing Ebola patients were recruited. All were healthy no signs or symptoms. AFA used were Liquid Soap & Alcohol 80%. The Control was Standard of Care. As they donned goggles the time taken to fog was noted, side effects and impact were all noted for each HCW after they had doffed off their Personal Protective Equipment (PPE). AFA was significant if P < 0.05 with a 95% Confidence Interval. Study findings; 66.7% of those that used liquid soap never fogged after 4 hours in PPE with p <0.001, The participants who used Alcohol all fogged 30 minutes after donning with p=0.030, and on the standard of care all of them fogged within 21 minutes of donning PPE with p=0.552. In this study over 90% who fogged could not see and stopped working. Of those who fogged 43 % developed dizziness and 53% developed headache. This study has demonstrated liquid soap is a superior AFA and thus increased the time the health care workers spend attending to critically ill Ebola patients and it reduces chances of infection among health care workers resulting from fogging of goggles. This study recommends WHO and MoH to include in their IPC guidelines the use of liquid soap as an antifogging agent for the goggles and face shields during donning in order to improve the level of care in the Isolation Treatment Centres.